Role of Plain Abdominal X-Ray in the Differential Diagnosis of Common Acute Abdominal Conditions in Children at Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria

Background: The plain abdominal x-ray is one of the commonly requested investigations in the children emergency room, paediatric surgical ward and neonatal wards. The short interval required to carry out this investigative procedure and obtain results makes it the first imaging modality used to unravel the different causes of acute abdominal conditions in children. The safety of abdominal x-ray in children makes it attractive for use in paediatric surgical practice as part of routine work-up for undifferentiated acute abdominal conditions and also to diagnose specific causes of acute abdomen in children. Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State. Objectives: Evaluation of the role of plain abdominal x-ray in diagnosing common acute abdominal conditions in children. Materials and method: Patients admitted to the children emergency room, paediatric surgical wards, children’s ward and neonatal ward who had plain abdominal x-ray as part of their diagnostic work-up were included in the study. They were studied prospectively between March 2011 and April 2021. Results: Three Hundred and Ninety-nine patients who had plain abdominal x-rays as part of their diagnostic work-up were studied. Males were 240 while females were 159, a male to female ratio of 1.5:1. The patients were aged between 1 day to 16 years. Differential diagnoses made with plain abdominal x-ray were intestinal obstruction in 298, perforated viscus 69 patients, intra-abdominal masses 13 patients and location of intra-abdominal foreign body 14. Intestinal obstruction cases in which plain abdominal x-ray played a role in their diagnosis and management included the following: intussusception 66, neonatal sepsis 60, malrotation 48, intestinal atresia 42, anorectal malformation 32, hirschsprung’s disease in 30 cases, pyloric stenosis 24, obstructed hernia 22, post-operative adhesions 16 and intestinal helminthiasis 12. Perforated viscus accounted for 69 indications. Out of these indications, perforated gut in intussusception 19, perforated typhoid ileitis was responsible in 13 cases, gut perforation in blunt abdominal trauma 8, perforation in strangulated hernia 11 cases, perforated gut in malrotation 7, ceacal perforation in hirschsprugs disease 6 and colonic perforation in necrotizing enterocolitis 5 cases. Conclusion: Plain abdominal x-ray remains a role to play in the differential diagnosis and management of common paediatric acute abdominal conditions.

Computer-Aided Diagnosis for Tuberculosis Classification with Water Strider Optimization Algorithm

Computer-aided diagnosis(CAD)models exploit artificial intelligence(AI)for chest X-ray(CXR)examination to identify the presence of tuberculosis(TB)and can improve the feasibility and performance of CXR for TB screening and triage.At the same time,CXR interpretation is a time-consuming and subjective process.Furthermore,high resemblance among the radiological patterns of TB and other lung diseases can result in misdiagnosis.Therefore,computer-aided diagnosis(CAD)models using machine learning(ML)and deep learning(DL)can be designed for screening TB accurately.With this motivation,this article develops a Water Strider Optimization with Deep Transfer Learning Enabled Tuberculosis Classification(WSODTL-TBC)model on Chest X-rays(CXR).The presented WSODTL-TBC model aims to detect and classify TB on CXR images.Primarily,the WSODTL-TBC model undergoes image filtering techniques to discard the noise content and U-Net-based image segmentation.Besides,a pre-trained residual network with a two-dimensional convolutional neural network(2D-CNN)model is applied to extract feature vectors.In addition,the WSO algorithm with long short-term memory(LSTM)model was employed for identifying and classifying TB,where the WSO algorithm is applied as a hyperparameter optimizer of the LSTM methodology,showing the novelty of the work.The performance validation of the presented WSODTL-TBC model is carried out on the benchmark dataset,and the outcomes were investigated in many aspects.The experimental development pointed out the betterment of the WSODTL-TBC model over existing algorithms.

Comparing upper gastrointestinal X-ray and endoscopy for gastric cancer diagnosis in Korea

AIM:To compare the cost and accuracy of upper gastrointestinal(GI)X-ray and upper endoscopy for diagnosis of gastric cancer using data from the 2002-2004 Korean National Cancer Screening Program(NCSP). METHODS:The study population included 1 503 646 participants in the 2002-2004 stomach cancer screening program who underwent upper GI X-ray or endoscopy.The accuracy of screening was defined as the probability of detecting gastric cancer.We calculated the probability by merging data from the NCSP and the Korea Central Cancer Registry.We estimated the direct costs of the medical examination and the tests for up- per GI X-ray,upper endoscopy,and biopsy. RESULTS:The probability of detecting gastric cancervia upper endoscopy was 2.9-fold higher than via upper GI X-ray.The unit costs of screening using upper GI X-ray and upper endoscopy were$32.67 and$34.89, respectively.In 2008,the estimated cost of identifying one case of gastric cancer was$53094.64 using upper GI X-ray and$16 900.43 using upper endoscopy.The cost to detect one case of gastric cancer was the same for upper GI X-ray and upper endoscopy at a cost ratio of 1:3.7. CONCLUSION:Upper endoscopy is slightly more costly to perform,but the cost to detect one case of gastric cancer is lower.

Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques

Effective prevention and management of osteoporosis would require suitable methods for population screenings and early diagnosis. Current clinicallyavailable diagnostic methods are mainly based on the use of either X-rays or ultrasound(US). All X-ray based methods provide a measure of bone mineral density(BMD), but it has been demonstrated that other structural aspects of the bone are important in determining fracture risk, such as mechanical features and elastic properties, which cannot be assessed using densitometric techniques. Among the most commonly used techniques, dual X-ray absorptiometry(DXA) is considered the current 'gold standard' for osteoporosis diagnosis and fracture risk prediction. Unfortunately, as other X-ray based techniques, DXA has specific limitations(e.g., use of ionizing radiation, large size of the equipment, high costs, limited availability) that hinder its application for population screenings and primary care diagnosis. This has resulted in an increasing interest in developing reliable pre-screening tools for osteoporosis such as quantitative ultrasound(QUS) scanners, which do not involve ionizing radiation exposure and represent a cheaper solution exploiting portable and widely available devices. Furthermore, the usefulness of QUS techniques in fracture risk prediction has been proven and, with the last developments, they are also becoming a more and more reliable approach for assessing bone quality. However, the US assessment of osteoporosis is currently used only as a pre-screening tool, requiring a subsequent diagnosis confirmation by means of a DXA evaluation. Here we illustrate the state of art in the early diagnosis of this 'silent disease' and show up recent advances for its prevention and improved management through early diagnosis.

A Comprehensive Investigation of Machine Learning Feature Extraction and ClassificationMethods for Automated Diagnosis of COVID-19 Based on X-ray Images

The quick spread of the CoronavirusDisease(COVID-19)infection around the world considered a real danger for global health.The biological structure and symptoms of COVID-19 are similar to other viral chest maladies,which makes it challenging and a big issue to improve approaches for efficient identification of COVID-19 disease.In this study,an automatic prediction of COVID-19 identification is proposed to automatically discriminate between healthy and COVID-19 infected subjects in X-ray images using two successful moderns are traditional machine learning methods(e.g.,artificial neural network(ANN),support vector machine(SVM),linear kernel and radial basis function(RBF),k-nearest neighbor(k-NN),Decision Tree(DT),andCN2 rule inducer techniques)and deep learningmodels(e.g.,MobileNets V2,ResNet50,GoogleNet,DarkNet andXception).A largeX-ray dataset has been created and developed,namely the COVID-19 vs.Normal(400 healthy cases,and 400 COVID cases).To the best of our knowledge,it is currently the largest publicly accessible COVID-19 dataset with the largest number of X-ray images of confirmed COVID-19 infection cases.Based on the results obtained from the experiments,it can be concluded that all the models performed well,deep learning models had achieved the optimum accuracy of 98.8%in ResNet50 model.In comparison,in traditional machine learning techniques, the SVM demonstrated the best result for an accuracy of 95% and RBFaccuracy 94% for the prediction of coronavirus disease 2019.

Exploratory Application of X-ray Photography in the Diagnosis of Poultry Fatty Liver

[Objectives]This study was conducted to explore the application value of X ray in the diagnosis of poultry fatty liver.[Methods]Serum biochemical tests were performed on laying hens with suspected fatty liver.The X-ray liver images of the left lateral position were observed.And the liver traits were observed by anatomy.[Results]The increase in liver space occupying lesion observed by X-ray photography was consistent with the increase in liver volume observed by anatomy.The biochemical test showed slight liver function abnormalities.[Conclusions]X-ray examination can be used for the auxiliary diagnosis of poultry fatty liver.

X-ray DIAGNOSIS OF EXTRASKELETAL (SOFT TISSUE) CHONDROSARCOMA (A REPORT OF 8 CASES)

Eight cases of surgically and pathologically verified extraskeletal (soft tissue) chondrosarcoma were analyzed with regard to clinical and X-ray features. The cardinal clinical aspects of this series are: presence of a local soft tissue mass; gradual enlargement of the mass accompanied by increasing pain. The X-ray signs were summarized as follows: formation of a soft tissue mass; various forms of calcifications concentrated in the central area of the tumor; in some instances, presence of a saucer-like defect on the cortical surface of neighbouring bone and periosteal proliferation with mound-like new bone on both sides as well as bending deformity of the affected bone. The incidence and sites of predilection, the main X-ray findings, radiological diagnosis and differential diagnosis of the tumor were discussed. The Roentgen features of synovial chondrosarcoma of the knee joint were especially analyzed.

X-ray DIAGNOSIS OF JUXTACORTICAL CHONDROSARCOMA (A REPORT OF 16 CASES)

The clinical and radiologic features of 16 cases of surgically and pathologically proved juxtacortical chondrosarcoma were analyzed. The main radiograp-hic findings include: (1) A saucerlike or scalloped defect confined to the outer surface of cortex dut to tumor erosion; (2) Localized cortical proliferation and sclerosis; (3) Soft tissue mass and various forms of calcification within the tumor; but without a bony or calcified shell around the tumor mass and (4) sunray and/or laminated periosteal reaction. The origin of this tumor, its histopathology and classification were discussed. A preliminary investigation on the radiated periosteal reaction and its pathological basis was performed.

Detecting Tuberculosis from Vietnamese X-Ray Imaging Using Transfer Learning Approach

Deep learning created a sharp rise in the development of autonomous image recognition systems,especially in the case of the medical field.Among lung problems,tuberculosis,caused by a bacterium called Mycobacterium tuberculosis,is a dangerous disease because of its infection and damage.When an infected person coughs or sneezes,tiny droplets can bring pathogens to others through inhaling.Tuberculosis mainly damages the lungs,but it also affects any part of the body.Moreover,during the period of the COVID-19(coronavirus disease 2019)pandemic,the access to tuberculosis diagnosis and treatment has become more difficult,so early and simple detection of tuberculosis has been more and more important.In our study,we focused on tuberculosis diagnosis by using the chestX-ray image,the essential input for the radiologist’s profession,and researched the effectiveness of the transfer learning approach in the case study of Vietnamese chest X-ray images.We proposed four strategies to clarify our hypothesis in different ways of applying transfer learning and different training set types.We also prepared a Vietnamese X-ray image dataset with the support of the VRPACS team to provide the basis for training and testing deep learning models.Our experiments were carried out by applying three different architectures,Alexnet,Resnet,and Densenet,on international,Vietnamese,and combined X-ray image datasets.After training,all models were verified on a pure Vietnamese X-rays set.The results show that transfer learning is suitable in the case study of Vietnamese chest X-ray images with high evaluating metrics in terms of AUC(Area under the Receiver Operating Characteristic Curve),sensitivity,specificity,and accuracy.In the best strategy,most of the scores were more than 0.93,and all AUCs were more than 0.98.

Value of CT scan in the diagnosis of primary large bowel lymphoma

Objective: To study the CT imaging of primary large bowel lymphoma and evaluate the value of CT scan. Methods: CT reports of 8 patients with proven primary large bowel lymphoma were retrospectively reviewed. Plain CT scans were done on all patients, enhanced CT scans simultaneously with 5-10 mm section thickness, and 5-10 mm table increments in 6 cases. Results: Primary involved sites were on the cecum (n=3), the ascending colon (n=2), and the rectum (n=1). The tumor was found in multiple areas of the large bowel in 2 cases. CT appearance fell into 3 typical patterns in our study. The first was focal mass type in 2 cases, with one combined with intussusception and retroperitoneal adenopathy; the second was segmental annular involvement type in 3 cases, with one of them combined with mesenteric adenopathy; the last was diffuse involvement type in 2 cases. Multiple nodules were seen in the rectum in 1 case. Conclusion: CT was found to be accurate in detecting the primary sites and complications of lymphoma, and evaluating invasion of adjacent structures; Focal mass type, segmental annular involvement type and diffuse involvement type are the main patterns of CT features in the primary large bowel lymphoma; The features revealed by CT scan are suggestive of primary large bowel lymphoma in some cases.

Prenatal Diagnosis of Proximal Femoral Focal Deficiency Combining Ultrasound and Computer Tomography

Four cases of proximal femoral focal deficiency (PFFD) in an otherwise healthy infant are described. Antenatal diagnosis was made at 27, 23, 23 and 18 weeks of gestation by routine ultrasound (US) examination. Computer Tomography (CT) was performed after 30 weeks of gestation and confirmed the images obtained by US. The diagnosis was confirmed after delivery. These cases illustrate the importance of combining US and CT to improve accuracy of prenatal diagnosis of skeletal disorders.

Ultrafast two-dimensional x-ray imager with temporal fiducial pulses for laser-produced plasmas

It is challenging to make an ultrafast diagnosis of the temporal evolution of small and short-lived plasma in two dimensions. To overcome this difficulty, we have developed a well-timed diagnostic utilizing an x-ray streak camera equipped with a row of multi-pinhole arrays. By processing multiple sets of one-dimensional streaked image data acquired from various pinholes, we are capable of reconstructing high-resolution two-dimensional images with a temporal resolution of 38 ps and a spatial resolution of 18 μm. The temporal fiducial pulses accessed from external sources can advance the precise timing and accurately determine the arrival time of the laser. Moreover, it can correct the nonlinear sweeping speed of the streak camera. The effectiveness of this diagnostic has been successfully verified at the Shenguang-II laser facility,providing an indispensable tool for observing complex physical phenomena, such as the implosion process of laser-fusion experiments.

Role of contrast-enhanced serial/spot abdominal X-rays in perioperative follow-up of patients undergoing abdominal surgery:An observational clinical study

BACKGROUND Many imaging methods such as ultrasonography,computed tomography(CT),magnetic resonance imaging,and endoscopy are used to identify the problems or complications that occur in the perioperative period and to determine the appropriate therapeutic approach.Specialists at surgical clinics and intensive care units sometimes need diagnostic procedures that can give quick results or reveal unexpected results.In particular,rapid on-site evaluation of patients followed under intensive care conditions has several advantages.AIM To determine the problems developing in patients in the perioperative period by contrast-enhanced abdominal X-ray(CE-AXR),revealing their current status or defining the effectiveness of CE-AXR.METHODS The files of the patients who underwent hepatopancreatobiliary or upper gastrointestinal surgery,whose CE-AXR film was taken,were reviewed retrospectively.Abdominal X-ray radiographs taken after ingestion of a watersoluble contrast agent(iohexol,300 mg,50 cc vial)and its application in a drain,nasogastric tube,or stent were evaluated.The contribution of the data obtained in patients who underwent CE-AXR to the diagnosis,follow-up,and treatment processes and the effectiveness of the application were investigated.RESULTS CE-AXR was applied to 131 patients in our clinic,most of whom underwent hepatopancreatobiliary or upper gastrointestinal surgery.It was determined that the data obtained from CE-AXR films taken in 98(74.8%)of the patients contributed to the diagnosis,treatment,and follow-up expectations and positively affected the clinical processes.CONCLUSION CE-AXR is a simple procedure that can be applied anywhere,especially in intensive care patients and at bedside,with a portable X-ray device.The simplicity of the procedure,less radiation exposure for the patients,less time wastage,reduction in the CT and endoscopy procedure burden and costs,quick results,rapid assessment of the situation,and enabling the monitoring of processes with repetitive procedures are important advantages.X-rays taken will be useful in terms of being a reference value during the follow-up period of the patient and determining the situation in medicolegal processes.

子宫输卵管造影术在辅助生殖技术助孕中的应用价值探讨

目的探讨X线子宫输卵管造影术(HSG)对输卵管性不孕症的临床诊断敏感度、特异度、符合率等情况。方法选取199例疑似输卵管性不孕症患者,所有患者均接受X线HSG检查,指定同一名具有高年资、高职称的临床影像学检查医师完成相关操作。记录检查结果,以其临床综合诊断结果为依据计算X线HSG检查对诊断输卵管性不孕症的敏感度、特异度、符合率等。结果所有患者均顺利完成X线HSG检查,其中通畅比例最高、阻塞比例最低。X线HSG检查阳性率(78.89%)与临床综合诊断阳性率(77.39%)对比,差异无统计学意义(P>0.05)。X线HSG检查对输卵管性不孕症诊断敏感度为96.75%,特异度为82.22%,符合率为93.47%。结论应用X线HSG检查对辅助诊断输卵管性不孕症具有较高的敏感度、特异度及符合率。

Combined molybdenum target X-ray and magnetic resonance imaging examinations improve breast cancer diagnostic efficacy

BACKGROUND Early-stage breast cancer patients often lack specific clinical manifestations,making diagnosis difficult.Molybdenum target X-ray and magnetic resonance imaging(MRI)examinations both have their own advantages.Thus,a combined examination methodology may improve early breast cancer diagnoses.AIM To explore the combined diagnostic efficacy of molybdenum target X-ray and MRI examinations in breast cancer.METHODS Patients diagnosed with breast cancer at our hospital from March 2019 to April 2021 were recruited,as were the same number of patients during the same period with benign breast tumors.Both groups underwent molybdenum target X-ray and MRI examinations,and diagnoses were given based on each exam.The single(i.e.,X-ray or MRI)and combined(i.e.,using both methods)diagnoses were counted,and the MRI-related examination parameters(e.g.,T-wave peak,peak and early enhancement rates,and apparent diffusion coefficient)were compared between the groups.RESULTS In total,63 breast cancer patients and 63 benign breast tumor patients were recruited.MRI detected 53 breast cancer cases and 61 benign breast tumor cases.Molybdenum target X-ray detected 50 breast cancer cases and 60 benign breast tumor cases.The combined methodology detected 61 breast cancer cases and 61 benign breast tumor cases.The sensitivity(96.83%)and accuracy(96.83%)of the combined methodology were higher than single-method MRI(84.13%and 90.48%,respectively)and molybdenum target X-ray(79.37%and 87.30%,respectively)(P<0.05).The combined methodology specificity(96.83%)did not differ from singlemethod MRI(96.83%)or molybdenum target X-ray(95.24%)(P>0.05).The Twave peak(169.43±32.05)and apparent diffusion coefficient(1.01±0.23)were lower in the breast cancer group than in the benign tumor group(228.86±46.51 and 1.41±0.35,respectively).However,the peak enhancement rate(1.08±0.24)and early enhancement rate(1.07±0.26)were significantly higher in the breast cancer group than in the benign tumor group(0.83±0.19 and 0.75±0.19,respectively)(P<0.05).CONCLUSION Combined molybdenum target X-ray and MRI examinations for diagnosing breast cancer improved the diagnostic sensitivity and accuracy,minimizing the missedand misdiagnoses risks and promoting timely treatment intervention.

Ray tracing method for the grazing incidence flat-field imaging soft X-ray spectrometer

A ray tracing method is introduced for helping adjustment and spectra analysis of the grazing incidence flat-field imaging soft X-ray spectrometer. For a single point source, the spectra images obtained by separate components, the toroidal mirror, and the grazing incidence flat-field concave grating with varied line spaces are given respectively. The calculated spectral images of the single point source by the spectrometer are also given for comparison with measurements with different experimental alignments.

Predicting and Suppressing Oversensing of a Pacemaker in Plain X-Ray Photography

We conducted experiments of oversensing generation of pacemaker (PM) and X-irradiation direction dependency of PM, and examined the oversensing suppression method, using 8 different types of PMs. It was found out from this experiment that oversensing would occur when some conditions (X-irradiation direction, X-irradiation intensity) are met. Oversensing occurred with the most low irradiation conditions (kV × mA) when PM was irradiated at 90° (vertically to C-MOS;Complementary Metal Oxide Semiconductor). The acuter the angle of irradiation is (α > 90° < α), the higher the irradiation conditions (kV × mA) at which oversensing start to occur. In plain X-ray photography, oversensing was confirmed under the irradiation conditions of (cervical spine, thoracic spine, lateral thoracic spine, rib, shoulder joint, collarbone, humerus, and chest).Once the irradiation angle and irradiation conditions (kV × mA) are available, oversensing is predictable to some extent. Our findings will help to predict oversensing generation of plain X-ray photography and suppress oversensing. Oversensing can be suppressed in most of the radiography by lowering tube current to 100 mA, but a 1.0 mm High-Density Tungsten Sheet must be put on PM in high tube voltage radiography.

Computer-Aided Design of X-Ray Microtomographic Scanners

The article is to study the development of computer-aided design of X-ray microtomography—the device for investigating the structure and construction of three-dimensional images of organic and inorganic objects on the basis of shadow projections. This article provides basic information regarding CAD of X-ray microtomography and a scheme consisting of three levels. The article also shows basic relations of X-ray computed tomography, the generalized scheme of an X-ray microtomographic scanner. The methods of X-ray imaging of the spatial microstructure and morphometry of materials are described. The main characteristics of an X-ray microtomographic scanner, the X-ray source, X-ray optical elements and mechanical components of the positioning system are shown. The block scheme and software functional scheme for intelligent neural network system of analysis of the internal microstructure of objects are presented. The method of choice of design parameters of CAD of X-ray microtomography aims at improving the quality of design and reducing costs of it. It is supposed to reduce the design time and eliminate the growing number of engineers involved in development and construction of X-ray microtomographic scanners.

Application of X-ray digital tomosynthesis in knee joint trauma examination

Objective: To explore the clinical value of X-ray digital tomosynthesis(DTS)in the diagnosis of knee joint fractures. Methods: A total of 28 cases of thoracic trauma, X-ray film cannot be clearly diagnosed or can confirm the diagnosis but the need for further identification of forensic diagnosis of cases of DTS scan and three-dimensional reconstruction in order to control the study. Results: 1. The reconstructed images after DTS scanning showed that the knee joint fractures were clearly diagnosed, and the detection rate of 28 knee joint fractures was 92.86%. 2. DTS scanning could clearly detect the fresh knee joint fracture's fracture line, corresponding line and broken bones. For the old fracture, DTS scanning could clearly show the condition of the fracture end's healing. Conclusions: The technique is of great value in the diagnosis of knee joint fracture, especially in the examination of complex structure, thick body and review of internal fixation after fracture.

女性不孕症中子宫输卵管造影的诊断价值研究

目的:研究女性不孕症中子宫输卵管造影的诊断价值。方法:取62例不孕症女性患者作为研究对象,均行子宫输卵管造影术,观察患者子宫造影情况、输卵管造影情况及造影并发症。结果:45例子宫形态正常(72.58%),17例子宫异常;35例输卵管畅通(56.45%),27例输卵管不畅(13.21%),其中11例输卵管堵塞;47例出现下腹疼痛症状(75.81%),27例出现阴道出血症状(43.55%),3例出现肠胃道反应症状(4.84%),2例出现发热症状(3.23%),1例静脉回流(1.62%)。经随访,30例患者在输卵管造影1年内成功自然怀孕,占比46.15%。结论:子宫输卵管造影术在女性不孕症诊断中具有较高价值,能显示患者子宫形态、输卵管走形,为临床判断输卵管形态异常提供科学依据,同时有助于提高怀孕率。