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At least 145 records · Page 8Linked to original sources
PubMed1982

The detection of thoracic abnormalities using posterior-anterior (PA) vs PA and oblique roentgenograms.

A reading trial was conducted as part of the 1978 Bay Area Asbestos Screening Project to evaluate the utility of adding oblique-view roentgenograms to standard posterior-anterior (PA) views. Chest films from a sample of 555 workers with histories of long-term asbestos exposure were read twice as PA and twice as PA + oblique sets, providing a basis for assessing reliability through intrareader, interreader, and intermethod agreement. The ancillary use of oblique view films resulted in higher rates of detection of asbestos-related abnormalities than with PA films alone, but the increased rates were gained at the expense of reliability in the interpretation process. Depending on the source of this unreliability, which requires further study, different remedial actions might be indicated. A reader's lack of experience could indicate the need for additional training, the use of several readers, an average over several reader judgements, or the development of standards for evaluating obliques. If, on the other hand, no way is found to reduce the unreliability, the use of oblique films in routine screening programs ought to be discouraged on the basis of measurement theory, since reliability is a prerequisite to validity.

Asbestos↗
PubMed1984

Chest roentgenograms in diagnosis of traumatic rupture of the aorta. Observer variation in interpretation.

A significant p value is not always a good measure of the clinical value of a diagnostic test. By examining interobserver agreement with respect to chest roentgenogram interpretation, we determined which of seven roentgenographic signs statistically associated with traumatic rupture of the aorta (TRA) are most likely to be useful in clinical practice. Four surgeons and two radiologists were asked to interpret individually, in blinded fashion, the initial chest films of 149 trauma patients who had undergone aortography to rule out TRA. Agreement between all observers, as well as between specialty groups, was examined by chi-square and by calculation of Cohen's kappa statistic, which estimates the extent of agreement. Statistically significant agreement (p = .0000) was found between all observers with regard to mediastinal widening and obscuration of the aortic knob, but other comparisons showed no better than random agreement. Of the seven roentgenographic signs associated with TRA, identification of mediastinal widening and obscuration of the aortic knob show the most consistent interobserver agreement and are the most likely to be useful in clinical practice.

Aorta, Thoracic↗
PubMed1986

Primary biliary cirrhosis. Subclinical inflammatory alveolitis in patients with normal chest roentgenograms.

To determine whether a subclinical inflammatory alveolitis is associated with primary biliary cirrhosis (PBC), we compared the numbers and types of cells recovered by bronchoalveolar lavage from 12 patients with PBC, ten healthy control subjects, and nine patients with alcoholic cirrhosis (AC). All were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. Total BAL cell count did not differ among patients with PBC (mean 9.6 X 10(4) cells/ml), patients with AC (mean 14.8 X 10(4) cells/ml), and control subjects (mean 9.9 X 10(4) cells/ml). Patients with PBC but not patients with AC had an increased proportion of lymphocytes in bronchoalveolar lavage fluid (respectively 22.4 percent +/- 5.2 and 11.6 percent +/- 2.52 compared with the normal value of 9.9 percent +/- 1.5 p less than 0.05). In the same way, alveolar lymphocytosis of the lower respiratory tract from PBC patients predominantly comprised T4+ (helper/inducer) T-lymphocyte subset in patients showing an increased alveolar lymphocytosis. Alveolar macrophages from PBC patients showed a dramatic increased chemiluminescence response before and after stimulation by phorbol-myristate-acetate, regardless of the intensity of alveolar lymphocytosis. Thus, our data demonstrated that subclinical alveolar inflammation comprising T-lymphocytes and activated alveolar macrophages mimicking sarcoid alveolitis is present in a high proportion of patients with PBC.

Adult↗
PubMed1987

Hypoxemia with normal chest roentgenogram due to Pneumocystis carinii pneumonia. Diagnostic errors due to low suspicion of AIDS.

Three patients encountered in a single month had insidious development of atypical respiratory or systemic symptoms and were found to be hypoxemic. All had normal chest roentgenograms and were perplexing problems in diagnosis. On initial presentation, none had evidence of pulmonary infection or recognized clinical or social features that suggested acquired immunodeficiency syndrome (AIDS). All received corticosteroids for respiratory distress before the correct diagnosis was made, and all died rapidly of Pneumocystis pneumonia secondary to AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Stump neuroma masquerading as recurrent malignancy on chest roentgenogram.

An amputation neuroma is a nerve's attempt at repair following amputation. While many are asymptomatic, some present as a painful mass. We describe a patient who, following a forequarter amputation for sarcoma, developed a stump neuroma that was unusual because it was first discovered on a routine chest roentgenogram.

Amputation Stumps↗
PubMed1991

Use of indium 111-labeled white blood cell scan in the diagnosis of cytomegalovirus pneumonia in a renal transplant recipient with a normal chest roentgenogram.

Opportunistic infections are common in patients after renal transplantation. This report describes a case of cytomegalovirus pneumonia in a renal transplant recipient with a normal chest roentgenogram and normal arterial oxygenation. An abnormal 111In-white blood cell scan led to the discovery of a pulmonary source of his recurrent fevers.

Adult↗
PubMed1992

Chest roentgenogram classification and clinical parameters in patients with active pulmonary tuberculosis.

The relationship between the clinical parameters and chest film appearance was studied in patients with active pulmonary tuberculosis. Patients with extended disease were often malnourished and had weak tuberculin reaction accompanied by lymphopenia. They excreted a large amount of mycobacterial bacilli and a longer period was required for negative conversion of sputum culture. We confirmed that the criteria for chest roentgenogram classification established by the Japanese Society for Tuberculosis ("Gakkai Classification") is useful in the estimation of the risk of infection and the prognosis of tuberculosis patients.

Adolescent↗
PubMed1975

Mediastinal neuroblastoma and ganglioneuroma. The differentiation between primary and secondary involvement on the chest roentgenogram.

The roentgenologic diagnosis and differentiation of mediastinal neurogenic tumors are possible on the chest roentgenogram as a rule. The soft tissue mass may be ill-defined and the tumor "ghost-like" in the case of primary neuroblastoma, but it is usually obvious in ganglioneuroma and metastatic disease. The presence of calcifications differentiates neurogenic tumors from other posterior mediastinal tumors of childhood. They are common in primary and rare in secondary disease. Rib erosions and displacement are striking in neuroblastoma (after a few months of age), more subtle in ganglioneuroma, and absent with secondary involvement. In 3 out of 7 posterior mediastinal neuroblastomas the diagnosis and treatment were delayed, as the adjacent rib changes were not appreciated for some time. "Dumbbell" shaped tumors are usually associated with vertebral changes and myelography is indicated even in the absence of neurologic deficit. Thoracic deformity and disability subsequent to laminectomy, radiation therapy, or both, are present in all survivors.

Child↗
PubMed1975

Measurement of fine structures in roentgenograms. III. Studies on root canals of teeth.

A study of the projection of root canals of natural teeth on dental roentgenograms was carried out as a sequel to an earlier phantom study. The material consisted of extracted teeth and teeth in situ in jaw preparations. The same radiation source and focus-film distance were used throughout, but the exposure times and tube voltages were varied. The roentgenographic images of the root canals were analysed densitometrically and compared with measurements of the actual object dimensions. The root were sectioned at the level studied and their cross sections were traced and measured with the aid of a profile projector. There was good agreement between the true breadth of the canal and that projected on the film. The maximum contrast in the image of the canal and the densitometrically measured difference in substance, expressed in metal equivalents, were proportional to the depth of the canal in the direction of radiation. The breadth of the canal in the plane of the film was the same regardless of whether the tube voltage was 50, 60 or 90 kV. On the other hand, the tube voltage affected the photographic density differences between the canal and the dentine walls. Changing the voltage from 50 to 60 kV did not affect the results, but there was a highly significant difference between 90 and 50 or 60 kV. The clinical significance of tube voltage and exposure time is discussed.

Absorptiometry, Photon↗
PubMed1999

[Retroperitoneal lipoma through the foramen of Bochdalek detected as a mass of chest roentgenogram: report of a case].

Retroperitoneal lipomas are relatively uncommon. They are generally asymptomatic tumors. We experienced a 70-year-old man who had retroperitoneal lipoma detected as a mass of chest roentgenogram. Transcutaneous needle biopsy yielded a diagnosis of lipoma. We performed surgical resection because the tumor was growing. The complete resection of the tumor was done uneventfully. The pathological diagnosis of the tumor was benign mature lipoma. The sagittal view of the chest MRI gave precise and useful anatomical informations. This tumor was considered to originate from the retroperitoneal fatty tissue at the subdiaphragmatic region and to extend into the posterior mediastinum though the foramen of Bochdalek. We present herein this case because of a unique growing form, which is the first report in the Japanese literature to our knowledge.

Aged↗
PubMed1999

Variation in the posterior vertebral contour line at the level of C-2 on lateral cervical roentgenograms: a method for odontoid fracture detection.

As an aid to the assessment of alignment and lordosis, four contour lines can be drawn on the lateral radiograph of the cervical spine. One of these contour lines is the posterior vertebral contour line, in which a smooth, gentle curve, convex anteriorly, is formed by a line drawn along the posterior margins of the cervical vertebral bodies. It is unknown whether discontinuity in the posterior contour line at this level represents a pathologic process of the odontoid. We analyzed the posterior cortex of C-2 and the odontoid in 500 lateral cervical spine radiographs to determine the amount of step-off (deviation from the posterior contour line) seen in normal lateral cervical roentgenograms. Only 15% (n = 75) showed any step-off; none exceeded 3 mm. We recommend that patients presenting with a history of cervical spine trauma who have a step-off at the posterior contour line at the odontoid/C-2 level of > or =3 mm should have fine-cut tomography or multiplanar computed tomography scanning to further assess the odontoid process and rule out fracture.

Adolescent↗
PubMed2002

The presenting chest roentgenogram in acute type A aortic dissection: a multidisciplinary study.

Acute type A aortic dissection requires early diagnosis and prompt surgical intervention. It is not entirely clear whether patients with this form of dissection have clear-cut chest roentgenogram (CXR) patterns or whether the CXR can guide the physician in directing further workup for acute aortic dissection. The purpose of this study is to evaluate the impact of the initial CXR in arousing suspicion for acute type A aortic dissection. Twelve physicians from four specialties (emergency medicine, radiology, cardiology, and cardiothoracic surgery) evaluated the presenting CXR of ten patients with acute type A aortic dissection and the CXRs of ten normal individuals in a blinded manner. They were asked whether the CXRs were normal or abnormal (part A) and what the findings were and then were asked whether the CXRs were suspicious for acute aortic dissection (part B) and what the findings were. In part A, of the normal CXRs 81 of 120 (68%) readings were recorded as normal. Of the dissection CXRs 112 of 120 (93%) readings were recorded as abnormal (P < 0.001). In part B, the physicians were asked specifically about suspicion for aortic dissection. Of the normal CXRs 101 of 120 (84%) readings were listed as not suspicious for dissection (i.e., 16% of the normal CXRs were listed as supsicious for dissection). Of the dissection CXRs 88 of 120 (73%) readings were recorded as suspicious for dissection (p < 0.001). The most frequent findings on a dissection CXR when physicians were specifically asked about dissection included widened mediastinum in 46 of 120 (38%) followed by not suspicious for dissection in 32 of 120 (27%). Among the physician specialties the only statistically significant finding was that the cardiology group was the most likely group to find an abnormality in a "normal" CXR. This data indicates that the presenting CXR is neither sensitive nor specific for acute type A dissection. In a patient with a suspicious history or physical examination, however, a CXR showing mediastinal widening or other aortic abnormalities should increase the suspicion for dissection and warrant further workup. Furthermore in a patient with a clinical suspicion a normal CXR reading should not delay echocardiography to rule out type A dissection.

Acute Disease↗
PubMed1992

A method to evaluate and compare roentgenograms.

A simple and practical method is suggested to evaluate and compare roentgenograms concerning optical density and contrast. The method is specifically indicated for research in which a metallic stepwedge penetrometer and a photodensitometer are used. A PC computer may be optionally employed for the mathematical and statistical processing of the data.

Contrast Media↗
PubMed1991

[Diagnosis of dental caries based on intra-oral roentgenograms].

On 238 intra-oral roentgenograms there were assessed carious process, shape, size, extent and depth of defects as well as the possibility of complications in teeth which were not treated. There were assessed 277 defects, out of which 194 in upper teeth and 83 in lower ones. In all the teeth of the maxilla and of the mandible there was found the greatest number of amorphic defects and semilunar contact surfaces. There were also observed a lot of defects in radiciform cementum, thus, often under the gingivae. These are sites difficult for access for clinical examination. That is why radiologic examination is often conclusive in localizing carious process and in accurate diagnosing in the case of pulpitis going on.

Dental Caries↗
PubMed1991

Correlation of lower respiratory tract inflammation with changes in lung function and chest roentgenograms in patients with untreated tropical pulmonary eosinophilia.

Forty-one patients with untreated tropical pulmonary eosinophilia (TPE) were studied to determine whether there was any relationship between lower respiratory tract inflammation and either changes in lung function or abnormalities in chest roentgenograms. Total number of inflammatory cells in bronchoalveolar lavage (BAL) fluid, consisting of alveolar macrophages, lymphocytes, eosinophils and neutrophils had significant negative correlations with transfer factor (TLCO) (r = 0.519, p less than 0.001), transfer coefficient (KCO) (r = 0.312, p less than 0.05) and total lung capacity (TLC) (r = 0.352, p less than 0.05). The absolute count of eosinophils in BAL fluid had a significant negative correlation with TLCO (r = 0.430, p less than 0.01) and KCO (r = 0.300, p = 0.05), but not with forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) or TLC. However, the absolute count of alveolar macrophages had a significant negative correlation with FVC (r = 0.343, p less than 0.05), FEV1 (r = 0.341, p less than 0.05) and TLC (r = 0.305, p less than 0.05), but not with TLCO or KCO. The total number of lymphocytes had a negative correlation with TLC (r = 0.315, p less than 0.05). There was no correlation between the types of cells recovered in BAL fluid and changes in chest radiographs as assessed by the ILO classification for occupational lung diseases. These data suggest that there may be a dissociation of pulmonary pathophysiological changes produced by different inflammatory cells in the lower respiratory tract. Macrophages and lymphocytes may produce more harm to the lung, as evidenced by significant negative correlations of these cells with lung volumes.

Adolescent↗
PubMedDate not supplied

[Evaluation of the periapical tissue lesions by roentgenogram].

Most of the periapical tissue lesions appear as radiolucent areas in a reontgenogram. However, several lesions of pulpal and periodontal origin as well as lesions caused by benign or malignant tumors appear in the roentgenogram as radiopaque areas. This article deals in detail with the classification, differential diagnosis and treatment of oral diseases which appear radiopaque in an X-ray film. Special attention is given to apical condensing osteitis, hypercementosis, chronic osteomyelitis and odontogenic tumors. These lesions are fairly common and the general practitioner should be familiar with their diagnosis and treatment.

Diagnosis, Differential↗
PubMed1990

[Bronchiectasis with normal paranasal sinus roentgenogram].

Bronchiectasis has come to be considered as a type of sinobronchial syndrome in Japan, but there exist some cases without chronic sinusitis. We studied the clinical features of 14 cases of bronchiectasis with definitely normal paranasal sinus roentgenogram, diagnosed during the past ten years. There were eleven middle-aged women and three men. Ten patients (71%) complained of hemoptysis, one (7%) of dry cough, one (7%) of productive cough, and the two (14%) had no complaint. In seven patients (50%) CT and bronchography showed localized cylindrical bronchiectasis in the right middle lobe and/or left upper lobe lingular division. They were considered to be middle lobe lingular syndrome. Three patients (22%) with localized varicose or cystic bronchiectasis had a history of pneumonia or pertussis in their infancy, so their bronchiectasis were considered secondary to infantile bronchopulmonary disease. Two patients (14%) had diffuse cystic bronchiectasis and were almost asymptomatic. They might be cases congenital bronchiectasis or Williams-Campbell syndrome. Pulmonary function tests were normal in most of the cases and sputum culture revealed no cases of persistent bacterial infection. These clinical features are quite different from those of bronchiectasis reported as sinobronchial syndrome, in which chronic productive cough, poor pulmonary function, persistent bacterial infection, etc. are significant. So we conclude that there are two distinct groups in bronchiectasis.

Adult↗
PubMed1990

[Bronchoscopic evaluation of 390 cases of hemoptysis without definite abnormality on the chest roentgenogram].

From Jan 1981 through Oct. 1988, fiberoptic bronchoscopic examination was undertaken in 390 patients with hemoptysis and basically normal chest roentgenogram or prominent pulmonary markings. A diagnosis of malignancy was made in sixteen cases (4.1 percent). The positive rates in was higher in those were heavy smokers or in patients of age greater than 40 years, whose bloody sputum rate were significantly higher than non-smoking patients whose age were less than 40 years, and patients coughed up cupfull of blood intermittently, (P less than 0.005). The absolute indication of bronchoscopic examination in patients with hemopstysis and a basically normal chest X-ray film are those who are greater than 40 years old, heavy smokers, coughing up bloody sputum and no improvement by active treatment for two weeks.

Adenocarcinoma↗