AIM:To investigate the value of C-arm Lipiodol computed tomography(CT) for intra-procedural hepatocellular carcinoma(HCC) lesion detection during transcatheter arterial chemoembolization(TACE).METHODS:Forty patients(3...AIM:To investigate the value of C-arm Lipiodol computed tomography(CT) for intra-procedural hepatocellular carcinoma(HCC) lesion detection during transcatheter arterial chemoembolization(TACE).METHODS:Forty patients(37 male,3 female;mean age,52.6 ± 12.5 years,age range:25-82 years) diagnosed with HCC were enrolled in this study.All patients underwent 64-slice CT 1-2 wk before TACE.During the procedure,hepatic angiography was performed first.Following diagnostic embolization with Lipiodol injected into the hepatic artery,a C-arm CT scan was immediately conducted(C-arm Lipiodol CT).If new HCC lesions were confirmed,gelfoam particles were super-selectively injected into the tumor-nourishing blood vessel.A Lipiodol CT scan was performed 7-14 d after TACE.All images acquired from 64-slice CT,digital subtraction angiography(DSA),C-arm Lipiodol CT and Lipiodol CT were retrospectively reviewed by four radiologists and the number of detected lesions in each examination was counted,respectively.The results of Lipiodol CT were taken as the diagnostic reference.Alpha-fetoprotein values were examined both before and after TACE.This study only takes into account the lesions that were not found or were considered suspicious on 64-slice CT before TACE.RESULTS:Preprocedural 64-slice CT detected a total of 13 suspicious lesions in the 40 patients.DSA detected ten definite and four suspicious lesions.C-arm Lipiodol CT detected 71 lesions in total and Lipiodol CT confirmed 67 lesions with a diameter range of 3-12 mm.Four false-positive lesions,which were detected by C-arm Lipiodol CT,were considered to be hepatic artery-portal vein fistulas.The average alpha-fetoprotein values before and after TACE were significantly different(452.3 ± 192.6 ng/m L vs 223.8 ± 93.2 ng/m L;P = 0.039).CONCLUSION:C-arm Lipiodol CT has a higher diagnostic sensitivity for small HCC lesions.This technique may help physicians make intraproceduraldecisions to provide patients with earlier treatment.展开更多
Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures t...Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures that meet the increased requirements are a priority in our time. X-ray examinations are of particular importance for the orthopedic and traumatological clinics, where they provide information about presence of a fracture in the patient’s body, about the concrete operation performed or about the effect of a suitable treatment. Along with their benefits X-rays have also a harmful effect. This requires special care to protect from this radiation. In this direction, research is constantly being done to improve the quality of radiation protection. Park MR, Lee KM and co-authors, compare the dose load obtained using C-arm and O-arm X-ray systems (which have the capability of combined 2D fluoroscopy and 3D computed tomography imaging). In their study, an orthopedic surgical procedure using C-arm and O-arm systems in 2D fluoroscopy modes was simulated. The radiation doses to susceptible organs of the operators were investigated. He results obtained show that the O-arm system delivered higher doses to the sensitive organs of the operator in all configurations [1]. The article of Stephen Balte briefly reviews the available technologies for measuring or estimation of patient skin dose in the interventional fluoroscopic environment, created by various X-ray equipment including C-arm systems. Given that many patients require multiple procedures, this documentation also aids in the planning of follow up visits [2]. Chong Hing Wong, Yoshihisa Kotani and co-authors evaluate the radiation exposures (RE) to the patient and surgeon during minimally invasive lumbar spine surgery with instrumentation using C-arm image intensifier or O-arm intraoperative CT. The results they get are in favor of the O-arm system [3]. The article “Virtual fluoroscopy for intraoperative C-arm positioning and radiation dose reduction” discusses positioning of an intraoperative C-arm system to achieve clear visualization of a particular anatomical feature by a system for virtual fluoroscopy (called FluoroSim) that could dramatically reduce time and received dose during the procedures. FluoroSim was found to reduce the radiation exposure required for C-arm positioning without reducing positioning time or accuracy, providing a potentially valuable tool to assist surgeons [4]. In our study, we performed practical measurements to show how the patient can be treated by applying most effective radiation protection when using a mobile C-arm X-ray system. For the study, we used exposure upon a phantom placed on the patient’s table. For an X-ray shielding, we used a protective apron with a lead equivalent of 1 mm, placed in two layers on the phantom. In each subsequent series of exposures, the protective apron was placed on the phantom, in a different position relative to the X-ray beam. The general conclusion of our study is that in order to obtain maximum protection from scattered radiation when using C-arm X-ray systems, the patient must be protected by a shielding with a suitable lead equivalent for the procedure performed which must be placed between patient’s body and X-ray tube, perpendicular to the X-ray beam pointed toward the region of interest.展开更多
目的探讨关节镜联合C型臂X线机治疗胫骨平台骨折的效果。方法方便选择2017年1月—2022年12月丹阳市人民医院收治的78例胫骨平台骨折患者为研究对象,以随机双盲法分为两组,每组39例。对照组行常规切开复位内固定术,观察组行关节镜联合C型...目的探讨关节镜联合C型臂X线机治疗胫骨平台骨折的效果。方法方便选择2017年1月—2022年12月丹阳市人民医院收治的78例胫骨平台骨折患者为研究对象,以随机双盲法分为两组,每组39例。对照组行常规切开复位内固定术,观察组行关节镜联合C型臂X线机微创内固定术,对两组手术疗效、手术指标、膝关节功能恢复与并发症发生情况进行分析比较。结果观察组手术优良率(97.44%)明显高于对照组(82.05%),差异有统计学意义(χ^(2)=5.014,P<0.05);观察组手术治疗相关指标优于对照组,差异有统计学意义(P均<0.05)。术后6个月两组患者Lysholm、纽约特种外科医院(Hospital for Special Surgery,HSS)评分均升高,且观察组Lysholm、HSS评分明显高于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(P均<0.05)。结论胫骨平台骨折患者采用关节镜联合C型臂X线机治疗的疗效确切,患者创伤小、术后恢复快、并发症少,且对患者膝关节功能的恢复有着明显的促进作用。展开更多
For a 3D C-arm computed tomography(CT) system, actual path of the scanner may deviate from the idea circle geometry because of mechanicalinstability,leading to perturbation artifacts in reconstructed images. In this p...For a 3D C-arm computed tomography(CT) system, actual path of the scanner may deviate from the idea circle geometry because of mechanicalinstability,leading to perturbation artifacts in reconstructed images. In this paper, we proposed a modified FBP method for the perturbed trajectories taking into account 6 perturbation parameters without tassuming any condition to be ideal. The preliminary studies demonstrated that this algorithm can acquire promising reconstruction image quality even when the perturbations are relatively large. The comparison of performances among different perturbation parameters is useful for constructing a C-arm CT system.展开更多
目的探讨C臂CT引导下经皮三叉神经半月节球囊压迫术治疗三叉神经痛的应用价值。方法回顾性分析采用C臂CT(Xper-CT)引导下经皮三叉神经半月节球襄压迫术治疗三叉神经痛患者40例,所有患者均进行C臂CT程序扫描,并通过X-travision工作站进...目的探讨C臂CT引导下经皮三叉神经半月节球囊压迫术治疗三叉神经痛的应用价值。方法回顾性分析采用C臂CT(Xper-CT)引导下经皮三叉神经半月节球襄压迫术治疗三叉神经痛患者40例,所有患者均进行C臂CT程序扫描,并通过X-travision工作站进行颅骨后处理重建,引导穿刺针进入卵圆孔及球囊到位,确定球囊头端位于Meckel’s腔,充盈球囊。术后记录手术剂量面积乘积(dose area product,DAP)、空气比释动能(cumulative air kerma,CAK)、曝光时间(fluo time,FT),分析辐射剂量。结果40例患者均通过C臂CT后处理重建技术引导卵圆孔穿刺成功(其中小卵圆孔2例);40例患者中通过C臂CT后处理重建技术确定球囊一次性到位并获得满意梨形21例(52%),通过C臂CT后处理重建技术分析后多次调整球囊位置及方向,使球囊头端位于岩骨切迹,并获得满意梨形12例(30%),7例(18%)患者未获得满意梨形。术后40例患者疼痛完全消失17例(42%),疼痛满意缓解21例(53%);疼痛缓解不满意2例(5%);总有效率95%。术后伴面部麻木26例(65%),咀嚼肌无力9例(23%)。40例患者DAP、CAK、FT分别为(79.39±23.15)Gycm^(2)、(245.07±84.04)mGy、(5.20±1.30)min。结论C臂CT引导下经皮三叉神经半月节球囊压迫术直观准确显示穿刺针、卵圆孔、球囊、岩骨脊的三维结构及其相互位置关系,尤其对解剖变异或异常增生的显示更具优势。展开更多
基金Supported by Funding from the Chinese Ministry of Science and Technology,No.2012BAI15B08International Cooperation Projects of the Ministry of Science and Technology,No.2012DFA30850
文摘AIM:To investigate the value of C-arm Lipiodol computed tomography(CT) for intra-procedural hepatocellular carcinoma(HCC) lesion detection during transcatheter arterial chemoembolization(TACE).METHODS:Forty patients(37 male,3 female;mean age,52.6 ± 12.5 years,age range:25-82 years) diagnosed with HCC were enrolled in this study.All patients underwent 64-slice CT 1-2 wk before TACE.During the procedure,hepatic angiography was performed first.Following diagnostic embolization with Lipiodol injected into the hepatic artery,a C-arm CT scan was immediately conducted(C-arm Lipiodol CT).If new HCC lesions were confirmed,gelfoam particles were super-selectively injected into the tumor-nourishing blood vessel.A Lipiodol CT scan was performed 7-14 d after TACE.All images acquired from 64-slice CT,digital subtraction angiography(DSA),C-arm Lipiodol CT and Lipiodol CT were retrospectively reviewed by four radiologists and the number of detected lesions in each examination was counted,respectively.The results of Lipiodol CT were taken as the diagnostic reference.Alpha-fetoprotein values were examined both before and after TACE.This study only takes into account the lesions that were not found or were considered suspicious on 64-slice CT before TACE.RESULTS:Preprocedural 64-slice CT detected a total of 13 suspicious lesions in the 40 patients.DSA detected ten definite and four suspicious lesions.C-arm Lipiodol CT detected 71 lesions in total and Lipiodol CT confirmed 67 lesions with a diameter range of 3-12 mm.Four false-positive lesions,which were detected by C-arm Lipiodol CT,were considered to be hepatic artery-portal vein fistulas.The average alpha-fetoprotein values before and after TACE were significantly different(452.3 ± 192.6 ng/m L vs 223.8 ± 93.2 ng/m L;P = 0.039).CONCLUSION:C-arm Lipiodol CT has a higher diagnostic sensitivity for small HCC lesions.This technique may help physicians make intraproceduraldecisions to provide patients with earlier treatment.
文摘Modern medicine is unthinkable without X-rays. Accurate diagnosis, leading to effective treatment, is largely based on precise X-ray examinations. The creation of new, modern equipment and various medical procedures that meet the increased requirements are a priority in our time. X-ray examinations are of particular importance for the orthopedic and traumatological clinics, where they provide information about presence of a fracture in the patient’s body, about the concrete operation performed or about the effect of a suitable treatment. Along with their benefits X-rays have also a harmful effect. This requires special care to protect from this radiation. In this direction, research is constantly being done to improve the quality of radiation protection. Park MR, Lee KM and co-authors, compare the dose load obtained using C-arm and O-arm X-ray systems (which have the capability of combined 2D fluoroscopy and 3D computed tomography imaging). In their study, an orthopedic surgical procedure using C-arm and O-arm systems in 2D fluoroscopy modes was simulated. The radiation doses to susceptible organs of the operators were investigated. He results obtained show that the O-arm system delivered higher doses to the sensitive organs of the operator in all configurations [1]. The article of Stephen Balte briefly reviews the available technologies for measuring or estimation of patient skin dose in the interventional fluoroscopic environment, created by various X-ray equipment including C-arm systems. Given that many patients require multiple procedures, this documentation also aids in the planning of follow up visits [2]. Chong Hing Wong, Yoshihisa Kotani and co-authors evaluate the radiation exposures (RE) to the patient and surgeon during minimally invasive lumbar spine surgery with instrumentation using C-arm image intensifier or O-arm intraoperative CT. The results they get are in favor of the O-arm system [3]. The article “Virtual fluoroscopy for intraoperative C-arm positioning and radiation dose reduction” discusses positioning of an intraoperative C-arm system to achieve clear visualization of a particular anatomical feature by a system for virtual fluoroscopy (called FluoroSim) that could dramatically reduce time and received dose during the procedures. FluoroSim was found to reduce the radiation exposure required for C-arm positioning without reducing positioning time or accuracy, providing a potentially valuable tool to assist surgeons [4]. In our study, we performed practical measurements to show how the patient can be treated by applying most effective radiation protection when using a mobile C-arm X-ray system. For the study, we used exposure upon a phantom placed on the patient’s table. For an X-ray shielding, we used a protective apron with a lead equivalent of 1 mm, placed in two layers on the phantom. In each subsequent series of exposures, the protective apron was placed on the phantom, in a different position relative to the X-ray beam. The general conclusion of our study is that in order to obtain maximum protection from scattered radiation when using C-arm X-ray systems, the patient must be protected by a shielding with a suitable lead equivalent for the procedure performed which must be placed between patient’s body and X-ray tube, perpendicular to the X-ray beam pointed toward the region of interest.
文摘目的探讨关节镜联合C型臂X线机治疗胫骨平台骨折的效果。方法方便选择2017年1月—2022年12月丹阳市人民医院收治的78例胫骨平台骨折患者为研究对象,以随机双盲法分为两组,每组39例。对照组行常规切开复位内固定术,观察组行关节镜联合C型臂X线机微创内固定术,对两组手术疗效、手术指标、膝关节功能恢复与并发症发生情况进行分析比较。结果观察组手术优良率(97.44%)明显高于对照组(82.05%),差异有统计学意义(χ^(2)=5.014,P<0.05);观察组手术治疗相关指标优于对照组,差异有统计学意义(P均<0.05)。术后6个月两组患者Lysholm、纽约特种外科医院(Hospital for Special Surgery,HSS)评分均升高,且观察组Lysholm、HSS评分明显高于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(P均<0.05)。结论胫骨平台骨折患者采用关节镜联合C型臂X线机治疗的疗效确切,患者创伤小、术后恢复快、并发症少,且对患者膝关节功能的恢复有着明显的促进作用。
基金Doctoral Program of Higher Education of Chinagrant number:20093218110024+1 种基金International Science and Technology Cooperation Grantgrant number:BZ2008060
文摘For a 3D C-arm computed tomography(CT) system, actual path of the scanner may deviate from the idea circle geometry because of mechanicalinstability,leading to perturbation artifacts in reconstructed images. In this paper, we proposed a modified FBP method for the perturbed trajectories taking into account 6 perturbation parameters without tassuming any condition to be ideal. The preliminary studies demonstrated that this algorithm can acquire promising reconstruction image quality even when the perturbations are relatively large. The comparison of performances among different perturbation parameters is useful for constructing a C-arm CT system.
文摘目的探讨C臂CT引导下经皮三叉神经半月节球囊压迫术治疗三叉神经痛的应用价值。方法回顾性分析采用C臂CT(Xper-CT)引导下经皮三叉神经半月节球襄压迫术治疗三叉神经痛患者40例,所有患者均进行C臂CT程序扫描,并通过X-travision工作站进行颅骨后处理重建,引导穿刺针进入卵圆孔及球囊到位,确定球囊头端位于Meckel’s腔,充盈球囊。术后记录手术剂量面积乘积(dose area product,DAP)、空气比释动能(cumulative air kerma,CAK)、曝光时间(fluo time,FT),分析辐射剂量。结果40例患者均通过C臂CT后处理重建技术引导卵圆孔穿刺成功(其中小卵圆孔2例);40例患者中通过C臂CT后处理重建技术确定球囊一次性到位并获得满意梨形21例(52%),通过C臂CT后处理重建技术分析后多次调整球囊位置及方向,使球囊头端位于岩骨切迹,并获得满意梨形12例(30%),7例(18%)患者未获得满意梨形。术后40例患者疼痛完全消失17例(42%),疼痛满意缓解21例(53%);疼痛缓解不满意2例(5%);总有效率95%。术后伴面部麻木26例(65%),咀嚼肌无力9例(23%)。40例患者DAP、CAK、FT分别为(79.39±23.15)Gycm^(2)、(245.07±84.04)mGy、(5.20±1.30)min。结论C臂CT引导下经皮三叉神经半月节球囊压迫术直观准确显示穿刺针、卵圆孔、球囊、岩骨脊的三维结构及其相互位置关系,尤其对解剖变异或异常增生的显示更具优势。
