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PubMed1989

[Diagnostic capability of digital radiography of the chest using scanning laser stimulated luminescence].

Diagnostic capability of Fuji Computed Radiography (FCR) of the chest was compared to the conventional radiography (CoR) using regular film-screen system. FCR utilizes imaging plates of scanning laser stimulated luminescence. Visibility of 14 structures of the chest radiography was evaluated by 3 radiologists in 100 pairs of FCR and CoR which were taken at the same time with the same exposure factors. FCR was superior to CoR especially in observation of the mediastinum and areas behind the heart and diaphragm. The minor fissure was better seen on CoR. Superiority of FCR to CoR was thought to be mainly due to the processed image of FCR, and the so-called normal image of FCR had little diagnostic advantage. Simulated abnormal densities: nodular, alveolar, and interstitial densities with a chest phantom, were made, and detectability of alteration of these densities on FCR and CoR was evaluated by 19 radiologist, using ROC curve analysis. FCR and CoR revealed the similar diagnostic capability in nodular and interstitial densities. In alveolar densities, however, FCR was statistically inferior to CoR. Nineteen radiologists were divided into 3 groups by their experience in radiology, and comparison was made as to their diagnostic capability with FCR and CoR in the same manner as described above. There was no significant difference among the groups with FCR in either density pattern.

Humans↗
PubMed1988

Bone scanning and radiography in the evaluation of patients with malignant lymphoma.

The diagnostic value of bone scintigraphy and radiography in the detection of lymphomatous bone involvement, and the role of bone scintigraphy in the evaluation of lymphomatous bone marrow involvement, were investigated in 41 patients with malignant lymphoma. 10 patients had lymphomatous bone involvement. Whereas scintigraphy detected all the 10 cases, radiography was false negative in 2 cases. The lytic bone lesions on radiography were in most cases not detected by scintigraphy. Scintigraphy is insensitive for the detection of early bone marrow metastases. The simultaneous use of bone scanning and x-ray, however, seems to be helpful in the detection of lymphomatous bone involvement and consequently in the clinical management of patients with malignant lymphoma.

Adolescent↗
PubMedDate not supplied

Radiography and ultrasonography in paranasal sinusitis.

In order to analyze whether ultrasonography with a reasonable degree of confidence can replace radiography in the diagnosis of sinusitis, 138 patients with clinical signs of sinusitis were examined with both methods. It was found that maxillary sinus fluid was recognized ultrasonographically with a confidence that increased with the amount of fluid, judged from radiographic examinations. In a sub-group of 45 cases, fluid confirmed by maxillary sinus puncture was detected by ultrasonography in 35/45 sinuses (78%) and by radiology in 38/45 sinuses (84%). In patients with radiographically normal maxillary sinuses, the correlation to ultrasound was good. However, mucosal swelling and polyps or cysts observed at radiography were poorly demonstrated by ultrasonography. In addition, the ultrasound method was not reliable for frontal sinus diagnosis. It was concluded that ultrasonography can be recommended in maxillary sinusitis for follow-up of treatment and as a screening method before sinus radiography.

Adult↗
PubMedDate not supplied

Chest radiography after minor chest trauma.

The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6 (30%) of the 20 patients with hemo/pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma.

Adolescent↗
PubMed1986

[Evaluation and treatment of lateral ankle sprain in the emergency department: is systematic radiography necessary?].

The authors describe the presentation, clinical evaluation and treatment of 151 patients (mean age 36.3 years) who presented to an outpatient clinic or the emergency department between Oct. 29, 1984, and Apr. 15, 1985, for a lateral ankle sprain. About 60% of the sprains were considered minor. Although 141 patients underwent simple radiography of the ankle on the first visit, only five fractures were identified. All the fractures were uncomplicated and were treated conservatively. No common criteria could be identified to explain why some patients with sprains of moderate severity were referred to an orthopedist while others were not. Of the 53 patients interviewed, 22 still had some limitation of physical activity 6 weeks after the sprain. The presence of malleolar soft-tissue swelling, pain in the bony structures and inability to bear weight should raise the suspicion of a fracture. If radiography had been limited to patients with these signs, no fracture would have been missed, and radiography would have been avoided in 70 cases.

Adolescent↗
PubMedDate not supplied

Radiography of pressure ulcers.

In patients with longstanding and/or deep pressure ulcers radiology is usually consulted. Survey radiography and sinography in 14 patients with pressure ulcers (6 over the tuber ischii and 8 over the femoral trochanter) were evaluated. Osteomyelitic involvement of adjacent bone was revealed in 9 patients on survey radiography. However, it was usually impossible to assess whether or not bony involvement represents healed or active osteomyelitis. Sinography did not contribute to the assessment of whether or not adjacent cortical bone was involved. However, when a fistulation to an adjacent joint was revealed this contributed substantially to the preoperative planning of resection. We therefore recommend that survey radiography and sinography should be included in the evaluation of these patients but that the results from such examinations are critically evaluated. Joint involvement should be taken seriously as progression of septic arthritis usually occurs rapidly.

Adult↗
PubMedDate not supplied

Diagnostic value of stress radiography in lesions of the lateral ligaments of the ankle.

The diagnostic accuracy of inversion and anterior stress radiography in rupture of the lateral ligaments of the ankle joint was assessed in 56 patients undergoing surgery. In inversion stress radiography, 58 per cent of the patients with confirmed rupture of the lateral ligaments of the ankle had a talar tilt of 10 degrees or more, allowing a predictive value of a positive test of 94 per cent. In anterior stress radiography, 53 per cent of the patients had a posterior tibiotalar distance of 9 mm or more, allowing a predictive value of a positive test of 81 per cent. In measurements of talar tilt and anterior displacement of the talus values higher than normal in the injured ankle may be a sign of a rupture of the lateral ligament.

Adolescent↗
PubMed1980

A study of the utilisation of skull radiography in 9 accident-and-emergency units in the U.K. A national study by the Royal College of Radiologists.

Over a period of ten weeks, nine accident-and-emergency units in England, Wales, and Scotland took part in an investigation into the use of skull radiography in the management of patients with head injury. 118 patients (2.0%) with linear fracture and 4 (0.07%) with depressed fracture were recorded in 5850 patients radiographed. Although only 1018 (17.4%) of these patients with head injury had significant additional injuries or pathology, they contributed just under half of the skull fractures detected. 90% of all requests for skull radiography were made by recently qualified doctors who, before radiography, classified 25.9% of their referrals as "fracture definitely absent". They were 99% accurate in this prediction. Traumatic intracranial haematoma and intracranial aerocele, conditions which the discovery of a skull fracture can help to anticipate, were recorded in 12.0 and 1.7 per 10,000 patients radiographed respectively.

Adolescent↗
PubMed1981

Costs and benefits of skull radiography for head injury. A national study by the Royal College of Radiologists.

Over a period of 10 weeks, nine accident-and-emergency units in England, Wales, and Scotland took part in an investigation into the use of skull radiography in the management of patients with head injury. The yield of potentially important radiological findings in 4829 patients with uncomplicated head injury was 2 basal, 1 frontal, and 64 vault fractures. In 4 of these patients intracranial haematomas developed, of which 3 would have been suspected clinically and the patients admitted for observation even if skull radiography had not been available. At best, skull radiography could have contributed to the detection of only 1 of the 4 intracranial haematomas. The incidence of unsuspected intracranial haematomas. The incidence of unsuspected intracranial haematoma with skull fracture among patients with uncomplicated head injury currently radiographed in the United Kingdom is therefore 1 in 4800. The radiological cost of identifying this 1 patient in our series was 43,200 pounds.

Adolescent↗
PubMed1983

Limiting the use of routine radiography for acute ankle injuries.

In the diagnosis of ankle injuries routine radiography is often productive. An international survey of the average number of radiographs made of injured ankles suggested that two projections are adequate to detect fractures. This was confirmed in a prospective study of 242 patients coming to a hospital emergency department with recent ankle injuries. All the fractures could be identified on an anteroposterior or a lateral projection, although some were more obvious on an oblique view. As well, all the fractures were associated with malleolar soft-tissue swelling. Thus, radiography for acute ankle injuries could safely be restricted to patients with soft-tissue swelling, and fractures could be diagnosed using only two routine projections, though for management purposes additional projections might be needed. With a policy of limiting the use of radiography substantial cost reductions are possible.

Acute Disease↗
PubMed1983

Reduction of radiation exposure during radiography for scoliosis.

To reduce the radiation exposure received by young scoliosis patients during treatment, six changes in technique were instituted: (1) a posteroanterior projection, (2) specially designed leaded acrylic filters, (3) a high-speed screen-film system, (4) a specially designed cassette-holder and grid, (5) a breast-shield, and (6) additional filtration in the x-ray tube the thyroid, breast, and abdominal areas were made on an Alderson phantom. They revealed an eightfold reduction in abdominal exposure for both the posteroanterior and the lateral radiographys. There was a twentyfold reduction in exposure to the thyroid for the posteroanterior radiography from 100 to less than five milliroentgens and for the lateral radiograph there was a 100-fold reduction from 618 to six milliroentgens. For the breasts there was a sixty-ninefold reduction from 344 to less than five milliroentgens for the posteroanterior radiography and a fifty-fivefold reduction from 277 to less than five milliroentgens for the lateral radiograph. These reductions in exposure were obtained without significant loss in the quality of the radiographs and in most instances with an improvement in the over-all quality of the radiograph due to the more uniform exposure.

Breast↗
PubMed1980

[Radiological study of painless knees in 50 men over 65 years of age. II. Axial projection and profile radiography (author's transl)].

Radiographs were taken in profile, and femoropatellar axial projection with 60 degrees flexion, in 50 men over 65 years of age who had never complained of symptoms related to their knees. Visible osteophytes of the patella are very frequently noted in profile radiography and were present in 35 subjects. Painless femoropatellar arthrosis is also frequent and this was noted on 60 degrees axial radiography in 7 subjects; unilaterally in 3 cases and bilaterally in 4 subjects. In 9 cases the femoropatellar arthrosis was external, while in 2 cases it was present both externally and internally. Detection of a patellar osteophyte on profile radiography does not necessarily imply the existence of femoropatellar arthrosis detectable radiologically on axial projection. This study was also able to define values for a certain number of the parameters of radiological morphology of the knee.

Aged↗
PubMed1996

Portable chest radiography techniques and teleradiology.

Despite the large number of portable examinations performed, the quality of bedside radiography is highly variable and has lagged behind the rapid advances in other fields of medical imaging. The authors discuss the technical factors of image production in relation to methods for improving image quality in portable radiography. Digital radiography has significant practical technical advantages in portable applications and also allows transmission and accessibility of images on a computer network.

Humans↗
PubMed1996

[The measurement parameters in dental radiography: a comparison between traditional and digital technics].

Digital and conventional techniques for dental, panoramic and intraoral radiography, were compared to assess measurement accuracy. The study was carried out on two plastic models of maxillary and mandibular arches, each containing 14 teeth extracted and positioned in their anatomical site. The teeth were prepared by opening the pulpal cavity and inserting endodontic wires within the canals. Intraoral x-ray images were taken with long-cone technique using a commercial high-resolution film and with a charge coupled device (CCD) sensor (radiovisiography). The models were then submitted to panoramic tomography with photostimulable phosphor plates. The length of the canals was measured on each image and compared to the length of the inserted wires. For the digital pictures, the measurement was performed directly on the monitor with the aid of electronic calipers. Magnification averages 3.40%, 9.47% and 14.11% for anterior teeth in intraoral radiography, in radiovisiography and panoramic radiography, respectively. The results demonstrate the presence of some degree of magnification for every radiographic procedure. This effect becomes statistically significant for both radiovisiography and digital panoramic techniques, especially in the latter. In spite of their well-known practical and dosimetric advantages, digital techniques in dental radiology must be used carefully whenever a reliable measurement is required.

Analysis of Variance↗
PubMedDate not supplied

Comparison of inter-observer reproducibility between conventional chest radiography and AMBER in the evaluation of silicosis.

The aims of this study were to test inter-observer and intraobserver agreement in the diagnosis of silicosis using conventional chest radiography and AMBER. One hundred and fifteen patients underwent chest x-rays and AMBER for the diagnosis of silicosis. Five readers blindly and independently evaluated the radiograms with standard ILO/UC classification scales. Reproducibility was assessed using ANOVA repeated measurements methods. AMBER showed a better technical quality of radiograms than conventional chest x-rays; interobserver reproducibility was high and similar (R = 0.75); intraobserver agreement between chest x-rays and AMBER was high ranging from 0.62 to 0.86 for the 5 readers. Notwithstanding the absence of standards for profusion classification, the interobserver reproducibility with AMBER was similar to that obtained with chest x-rays. Moreover, the intraobserver agreement in profusion scoring between AMBER and chest radiography was high, suggesting that AMBER and chest radiography provided similar information in the evaluation of silicosis.

Aged↗
PubMed1998

Diagnosing acute maxillary sinusitis in primary care: a comparison of ultrasound, clinical examination and radiography.

In primary care, acute maxillary sinusitis may be diagnosed by clinical examination, ultrasound or radiography. Previous studies on the diagnostic accuracy of these methods are from secondary care settings and may not be generalisable to primary care. In this study of 39 primary care patients we have compared ultrasound, clinical examination and radiography to sinus irrigation. The sensitivity of ultrasound performed by general practitioners is 61% and specificity is 53%. Diagnostic accuracy does not improve when the general practitioner bases the diagnosis on combination of clinical examination and ultrasound. The most accurate way to diagnose sinusitis is radiography and when the radiographs are interpreted by a radiologist (sensitivity: 61%; specificity: 98%). The accuracy of the ultrasound examination performed by general practitioners is poorer than earlier results from ENT practices. More attention should be paid to education and quality management in the use of ultrasound in primary care.

Acute Disease↗
PubMed1998

Diagnostic value of full-mouth radiography in dogs.

OBJECTIVE: To determine the diagnostic value of full-mouth radiography in dogs. SAMPLE POPULATION: Prospective series of 226 dogs referred for dental treatment without previous full-mouth radiographic views being available. PROCEDURE: In a prospective nested case-control analysis of multiple outcomes in a hospital cohort of dogs presented for dental treatment, full-mouth radiographic views were obtained prior to oral examination and charting. After treatment, clinical and radiographic findings were compared, with reference to presenting problems, main clinical findings, additional information obtained from the radiographs, and unexpected radiographic findings. The importance of the radiographic findings in therapeutic decision-making was assessed. RESULTS: The main clinical findings were radiographically confirmed in all dogs. Selected presenting problems and main clinical findings yielded significantly increased odds ratios for a variety of other conditions, either expected or unexpected. Radiographs of teeth without clinical lesions yielded incidental or clinically important findings in 41.7 and 27.8% of dogs, respectively, and were considered of no clinical value in 30.5%. Radiographs of teeth with clinical lesions merely confirmed the findings in 24.3% of dogs, yielded additional or clinically essential information in 50.0 and 22.6%, respectively, and were considered of no value in 3.1%. Older dogs derived more benefit from full-mouth radiography than did younger dogs. Incidental findings were more common in larger dogs. CLINICAL RELEVANCE: Diagnostic yield of full-mouth radiography in new canine patients referred for dental treatment is high, and the routine use of such radiographs is justifiable.

Age Factors↗
PubMed1998

Comparison of Ottawa ankle rules and current local guidelines for use of radiography in acute ankle injuries.

A prospective consecutive study of 252 adult patients presenting to Accident and Emergency (A&E) departments was performed to assess any advantage of the Ottawa vs. local guidelines for radiography of the acutely injured ankle or midfoot. All patients taking part in the study underwent an ankle or midfoot radiograph. A comparison was made to determine whether a safe reduction in radiography could be produced by following the Ottawa criteria. Simultaneously, the accuracy of both guidelines were assessed. Twenty-two fractures were diagnosed radiologically. Both guidelines had a sensitivity of 1.0 in detecting fractures and a negative predictive value of 1.0. Ottawa guidelines produced a specificity of 0.48 and a positive predictive value of 0.15. Local guidelines produced a specificity of 0.19 and a positive predictive value of 0.1. Following Ottawa guidelines produced a highly significant reduction (X = 74.0 P < 0.001) in radiography of 37%, and no fractures were missed. This could potentially save the department approximately 7500 Pounds per annum.

Acute Disease↗