Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LU...Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.展开更多
The fast X-ray imaging beamline(BL16U2)at Shanghai Synchrotron Radiation Facility(SSRF)is a new beamline that provides X-ray micro-imaging capabilities across a wide range of time scales,spanning from 100 ps toμs and...The fast X-ray imaging beamline(BL16U2)at Shanghai Synchrotron Radiation Facility(SSRF)is a new beamline that provides X-ray micro-imaging capabilities across a wide range of time scales,spanning from 100 ps toμs and ms.This beamline has been specifically designed to facilitate the investigation of a wide range of rapid phenomena,such as the deformation and failure of materials subjected to intense dynamic loads.In addition,it enables the study of high-pressure and high-speed fuel spray processes in automotive engines.The light source of this beamline is a cryogenic permanent magnet undulator(CPMU)that is cooled by liquid nitrogen.This CPMU can generate X-ray photons within an energy range of 8.7-30 keV.The beamline offers two modes of operation:monochromatic beam mode with a liquid nitrogen-cooled double-crystal monochromator(DCM)and pink beam mode with the first crystal of the DCM out of the beam path.Four X-ray imaging methods were implemented in BL16U2:single-pulse ultrafast X-ray imaging,microsecond-resolved X-ray dynamic imaging,millisecond-resolved X-ray dynamic micro-CT,and high-resolution quantitative micro-CT.Furthermore,BL16U2 is equipped with various in situ impact loading systems,such as a split Hopkinson bar system,light gas gun,and fuel spray chamber.Following the completion of the final commissioning in 2021 and subsequent trial operations in 2022,the beamline has been officially available to users from 2023.展开更多
The COVID-19 pandemic has had a widespread negative impact globally. It shares symptoms with other respiratory illnesses such as pneumonia and influenza, making rapid and accurate diagnosis essential to treat individu...The COVID-19 pandemic has had a widespread negative impact globally. It shares symptoms with other respiratory illnesses such as pneumonia and influenza, making rapid and accurate diagnosis essential to treat individuals and halt further transmission. X-ray imaging of the lungs is one of the most reliable diagnostic tools. Utilizing deep learning, we can train models to recognize the signs of infection, thus aiding in the identification of COVID-19 cases. For our project, we developed a deep learning model utilizing the ResNet50 architecture, pre-trained with ImageNet and CheXNet datasets. We tackled the challenge of an imbalanced dataset, the CoronaHack Chest X-Ray dataset provided by Kaggle, through both binary and multi-class classification approaches. Additionally, we evaluated the performance impact of using Focal loss versus Cross-entropy loss in our model.展开更多
COVID-19 is a respiratory illness caused by the SARS-CoV-2 virus, first identified in 2019. The primary mode of transmission is through respiratory droplets when an infected person coughs or sneezes. Symptoms can rang...COVID-19 is a respiratory illness caused by the SARS-CoV-2 virus, first identified in 2019. The primary mode of transmission is through respiratory droplets when an infected person coughs or sneezes. Symptoms can range from mild to severe, and timely diagnosis is crucial for effective treatment. Chest X-Ray imaging is one diagnostic tool used for COVID-19, and a Convolutional Neural Network (CNN) is a popular technique for image classification. In this study, we proposed a CNN-based approach for detecting COVID-19 in chest X-Ray images. The model was trained on a dataset containing both COVID-19 positive and negative cases and evaluated on a separate test dataset to measure its accuracy. Our results indicated that the CNN approach could accurately detect COVID-19 in chest X-Ray images, with an overall accuracy of 97%. This approach could potentially serve as an early diagnostic tool to reduce the spread of the virus.展开更多
Introduction: The diagnosis of pneumonia is usually made based on clinical manifestations and chest X-ray. The use of ultrasound in detecting pulmonary diseases in general, and especially consolidation syndrome has be...Introduction: The diagnosis of pneumonia is usually made based on clinical manifestations and chest X-ray. The use of ultrasound in detecting pulmonary diseases in general, and especially consolidation syndrome has been demonstrated. The objective of this study was to determine the accuracy of thoracic ultrasound compared to chest X-ray in the diagnosis of infectious pneumonia in children. Methods: Children between 0 to 15 years were included in our study. The lung ultrasound results obtained were compared with those of the chest X-ray used as the reference. Our data were introduced into the EpiInfo 3.5.4 software and analyzed with the EpiInfo 3.5.4 and IBMSPSS Statistics version 20.0 softwares. Microsoft Office Excel 2016 was used to produce Charts. Continuous quantitative variables were presented. Cohen’s Kappa concordance test was applied with confidence interval of 95%. Results: 52 children were enrolled in the study. In imaging, the dominant sign was consolidation syndrome (75.0%) of cases by chest radiography, and in 78.8% of cases by lung ultrasound (p Conclusion: Our study demonstrated that lung echography is a non-ionizing and reliable tool in the diagnosis of childhood’s pneumonia.展开更多
Background: Chest X-ray is frequently performed for evaluation of chest disease in both adults and children. Children are more exposed to the adverse effects of radiation as compared to adults. During our daily practi...Background: Chest X-ray is frequently performed for evaluation of chest disease in both adults and children. Children are more exposed to the adverse effects of radiation as compared to adults. During our daily practice, we noticed that most of children’s chest X-ray results were normal. Purpose: This study aimed to evaluate the indications, the technic, the irradiation and the result of chest X-rays in children in order to know if the practice of these X-rays was relevant. Method: Cross-sectional and descriptive study conducted at the Imaging Regional Center of Ngaoundere from April to August 2017. A total number of 145 radiographs and 140 X-ray requests of 140 children were considered in this work. The conformity of the request were verified according to the recommendations of the National Agency for Accreditation and Health Evaluation in France (NAAHE), technical condition of realization and results were appreciated and the entrance surface dose (ESD) of the patients was estimated using a mathematical algorithm. Results: Children under 5 years (63.5%) were more represented in our study. The main indications were: cough (22.1%), suspicion of pneumonia (16.4%) and bronchitis (15.7%). No indication was mentioned on 69.3% of the request forms. After confrontation to the “Guide for proper use of medical imaging examinations” (GPU), we only had 24% conformity of indications. 82.7% of the examinations required immobilization assistance by the parents. Most of the children were imaged in a standing-up position (82.9%) and the anterior-posterior view (77.9%) was more practiced. After the analysis of the pictures, 62% of them presented an optimal contrast, while 42.1% of X-ray were performed without beam collimation. 25 X-rays were repeated: 12 (48%) because of patient’s motion and 13 (52%) of mispositionning. After interpretation, 87 (62.14%) chest X-ray were normal. Main lesion observed were pneumonia (17.14%) followed by bronchopeumopathy (5.71%) and bronchitis (5%). The obtained ESD values were 0.11, 0.15 and 0.17 mGy respectively for the 0 - 1 year, 1 - 5 year and 5 - 10 year age groups;0.2 and 0.57 respectively for postero-anterior (PA) and lateral (LAT) view for the age group 10 - 15 years, which were slightly greater than the values in internationally published studies. Conclusion: The request for children chest X-ray is not relevant in terms of indication, technical conditions of realization and irradiation.展开更多
Idiopathic pneumomediastinum is rare in children. Few cases of patients with pneumomediastinum show negative findings on X-ray examination. Chest computed tomography (CT) was very useful for the diagnosis and evaluati...Idiopathic pneumomediastinum is rare in children. Few cases of patients with pneumomediastinum show negative findings on X-ray examination. Chest computed tomography (CT) was very useful for the diagnosis and evaluation of the extent of pneumomediastinum. We report here a case of idiopathic pneumomediastinum in a 15-year-old boy who exhibited no significant chest X-ray finding. The patient was referred to our institute for the further evaluation of pre-cordial pain and breathing difficulty. Precordial pain suddenly developed, when he was carrying a portable shrine on his shoulder (day of onset). He was admitted to another institute 3 days after onset because of worsening precordial pain. On admission, he presented with 98% saturation of hemoglobin in the peripheral blood under room air. Plain chest X-ray also revealed no abnormal findings. A half-dissolved gastrographin swallow showed no leakage of gastrographin from the pharynx and esophagus to the mediastinum, and no diverticulum within the esophagus. Plain chest CT revealed extensive emphysema around the trachea from the neck to the portion inferior to the carina of trachea. The patient was diagnosed with idiopathic pneumomediastinum because the cause was unclear. We decided to admit him to our institute under fasting conditions and rest. His symptoms improved 3 days after onset. The lesion had disap-peared 8 days after onset on chest CT. When young people experience precordial pain which increases on inspiration, we must consider pneumomediastinum in a differential diagnosis, and it is important to perform chest CT.展开更多
BACKGROUND:The appropriate sequence of different imagings and indications of thoracic computed tomography(TCT)in evaluating chest trauma have not yet been clarified at present.The current study was undertaken to deter...BACKGROUND:The appropriate sequence of different imagings and indications of thoracic computed tomography(TCT)in evaluating chest trauma have not yet been clarified at present.The current study was undertaken to determine the value of chest X-ray(CXR)in detecting chest injuries in patients with blunt trauma.METHODS:A total of 447 patients with blunt thoracic trauma who had been admitted to the emergency department(ED)in the period of 2009–2013 were retrospectively reviewed.The patients met inclusion criteria(age>8 years,blunt injury to the chest,hemodynamically stable,and neurologically intact)and underwent both TCT and upright CXR in the ED.Radiological imagings were re-interpreted after they were collected from the hospital database by two skilled radiologists.RESULTS:Of the 447 patients,309(69.1%)were male.The mean age of the 447 patients was 39.5±19.2(range 9 and 87 years).158(35.3%)patients were injured in motor vehicle accidents(MVA).CXR showed the highest sensitivity in detecting clavicle fractures[95%CI 78.3(63.6–89)]but the lowest in pneuomediastinum[95%CI 11.8(1.5–36.4)].The specificity of CXR was close to 100%in detecting a wide array of entities.CONCLUSION:CXR remains to be the first choice in hemodynamically unstable patients with blunt chest trauma.Moreover,stable patients with normal CXR are candidates who should undergo TCT if significant injury has not been ruled out.展开更多
Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French Natio...Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French National Authority for Health in prescribing chest radiography. Methodology: We conducted a retrospective analysis study, in two radiology centers belonging to the same group in Saint-Omer and Aire-sur-la-Lys, of requests for chest radiography sent by general practitioners over the winter period between December 22, 2013, and March 21, 2014, for patients aged over 18 years. Results: One hundred and seventy-seven requests for chest X-rays were analyzed, 71.75% of which complied with recommendations. The most frequent reason was the search for bronchopulmonary infection, accounting for 70.08% of prescriptions, followed by 11.2% for requests to rule out pulmonary neoplasia, whereas the latter reason did not comply with recommendations. Chest X-rays contributed to a positive diagnosis in 28.81% of cases. The positive diagnosis was given by 36.22% of the recommended chest X-rays, versus 10% for those not recommended. Conclusion: In most cases, general practitioners follow HAS recommendations for prescribing chest X-rays. Non-recommended chest X-rays do not appear to make a major contribution to diagnosis or patient management, confirming the value of following the recommendations of the French National Authority for Health.展开更多
<strong>Objective:</strong> To investigate the time course and findings severity of COVID-19 infection at chest radiography based on a 6-point radiological severity score, and correlates these with patient...<strong>Objective:</strong> To investigate the time course and findings severity of COVID-19 infection at chest radiography based on a 6-point radiological severity score, and correlates these with patients’ age and gender. <strong>Methods:</strong> This is a retrospective study of COVID-19 patients who were admitted at European Gaza Hospital and evaluated between October 6, 2020, and November 30, 2020. Baseline and serial chest radiographs, up to 4 images per patient, were reviewed and assessed for predominant pattern, side, and location of lung opacity. Utilized a 6-point scoring system, which divides the chest X-ray into 6 zones, to assess chest X-ray changes and correlate them with the severity of infection, age, and gender of patients. <strong>Results</strong><strong>:</strong> The study included 136 COVID-19 patients: (51/136, 37%) were males and (85/136, 62.5%) were females, while age ranged from 7 months to 90 years with a mean age of 41.7 ± (19.5) years. Negative Chest x-rays were more observed than positive images. Ground-glass opacity was the most frequent pattern with a decreasing trend from 1st to 4th chest X-ray (from 33.8% to 3.7%), followed by consolidation (from 16.2% to 2.9%). Also, the commonest pattern of opacity was seen in peripheral areas (27/136, 19.9%), lower zone location (23/136, 16.9%), and bilateral opacity involvement (43/136;31.6%). No significant correlation was noticed between the patient’s gender, age, and severity score (P > 0.05). <strong>Conclusions</strong><strong>: </strong>The 6-point chest X-ray severity score as a predictive tool in assessing the severity due to provide an assessment of the progression or regression pathway.展开更多
<span style="font-family:Verdana;">Detecting and segmenting the lung regions in chest X-ray images is an important part in artificial intelligence-based computer-aided diagnosis/detection (AI-CAD) syst...<span style="font-family:Verdana;">Detecting and segmenting the lung regions in chest X-ray images is an important part in artificial intelligence-based computer-aided diagnosis/detection (AI-CAD) systems for chest radiography. However, if the chest X-ray images themselves are used as training data for the AI-CAD system, the system might learn the irrelevant image-based information resulting in the decrease of system’s performance. In this study, we propose a lung region segmentation method that can automatically remove the shoulder and scapula regions, mediastinum, and diaphragm regions in advance from various chest X-ray images to be used as learning data. The proposed method consists of three main steps. First, employ the simple linear iterative clustering algorithm, the lazy snapping technique and local entropy filter to generate an entropy map. Second, apply morphological operations to the entropy map to obtain a lung mask. Third, perform automated segmentation of the lung field using the obtained mask. A total of 30 images were used for the experiments. In order to verify the effectiveness of the proposed method, two other texture maps, namely, the maps created from the standard deviation filtering and the range filtering, were used for comparison. As a result, the proposed method using the entropy map was able to appropriately remove the unnecessary regions. In addition, this method was able to remove the markers present in the image, but the other two methods could not. The experimental results have revealed that our proposed method is a highly generalizable and useful algorithm. We believe that this method might act an important role to enhance the performance of AI-CAD systems for chest X-ray images.</span>展开更多
文摘Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.
基金supported by the CAS Project for Young Scientists in Basic Research(YSBR-096)the National Major Scientific Instruments and Equipment Development Project of China(No.11627901)+1 种基金the National Key Research and Development Program of China(Nos.2021YFF0701202,2021YFA1600703)the National Natural Science Foundation of China(Nos.U1932205,12275343).
文摘The fast X-ray imaging beamline(BL16U2)at Shanghai Synchrotron Radiation Facility(SSRF)is a new beamline that provides X-ray micro-imaging capabilities across a wide range of time scales,spanning from 100 ps toμs and ms.This beamline has been specifically designed to facilitate the investigation of a wide range of rapid phenomena,such as the deformation and failure of materials subjected to intense dynamic loads.In addition,it enables the study of high-pressure and high-speed fuel spray processes in automotive engines.The light source of this beamline is a cryogenic permanent magnet undulator(CPMU)that is cooled by liquid nitrogen.This CPMU can generate X-ray photons within an energy range of 8.7-30 keV.The beamline offers two modes of operation:monochromatic beam mode with a liquid nitrogen-cooled double-crystal monochromator(DCM)and pink beam mode with the first crystal of the DCM out of the beam path.Four X-ray imaging methods were implemented in BL16U2:single-pulse ultrafast X-ray imaging,microsecond-resolved X-ray dynamic imaging,millisecond-resolved X-ray dynamic micro-CT,and high-resolution quantitative micro-CT.Furthermore,BL16U2 is equipped with various in situ impact loading systems,such as a split Hopkinson bar system,light gas gun,and fuel spray chamber.Following the completion of the final commissioning in 2021 and subsequent trial operations in 2022,the beamline has been officially available to users from 2023.
文摘The COVID-19 pandemic has had a widespread negative impact globally. It shares symptoms with other respiratory illnesses such as pneumonia and influenza, making rapid and accurate diagnosis essential to treat individuals and halt further transmission. X-ray imaging of the lungs is one of the most reliable diagnostic tools. Utilizing deep learning, we can train models to recognize the signs of infection, thus aiding in the identification of COVID-19 cases. For our project, we developed a deep learning model utilizing the ResNet50 architecture, pre-trained with ImageNet and CheXNet datasets. We tackled the challenge of an imbalanced dataset, the CoronaHack Chest X-Ray dataset provided by Kaggle, through both binary and multi-class classification approaches. Additionally, we evaluated the performance impact of using Focal loss versus Cross-entropy loss in our model.
文摘COVID-19 is a respiratory illness caused by the SARS-CoV-2 virus, first identified in 2019. The primary mode of transmission is through respiratory droplets when an infected person coughs or sneezes. Symptoms can range from mild to severe, and timely diagnosis is crucial for effective treatment. Chest X-Ray imaging is one diagnostic tool used for COVID-19, and a Convolutional Neural Network (CNN) is a popular technique for image classification. In this study, we proposed a CNN-based approach for detecting COVID-19 in chest X-Ray images. The model was trained on a dataset containing both COVID-19 positive and negative cases and evaluated on a separate test dataset to measure its accuracy. Our results indicated that the CNN approach could accurately detect COVID-19 in chest X-Ray images, with an overall accuracy of 97%. This approach could potentially serve as an early diagnostic tool to reduce the spread of the virus.
文摘Introduction: The diagnosis of pneumonia is usually made based on clinical manifestations and chest X-ray. The use of ultrasound in detecting pulmonary diseases in general, and especially consolidation syndrome has been demonstrated. The objective of this study was to determine the accuracy of thoracic ultrasound compared to chest X-ray in the diagnosis of infectious pneumonia in children. Methods: Children between 0 to 15 years were included in our study. The lung ultrasound results obtained were compared with those of the chest X-ray used as the reference. Our data were introduced into the EpiInfo 3.5.4 software and analyzed with the EpiInfo 3.5.4 and IBMSPSS Statistics version 20.0 softwares. Microsoft Office Excel 2016 was used to produce Charts. Continuous quantitative variables were presented. Cohen’s Kappa concordance test was applied with confidence interval of 95%. Results: 52 children were enrolled in the study. In imaging, the dominant sign was consolidation syndrome (75.0%) of cases by chest radiography, and in 78.8% of cases by lung ultrasound (p Conclusion: Our study demonstrated that lung echography is a non-ionizing and reliable tool in the diagnosis of childhood’s pneumonia.
文摘Background: Chest X-ray is frequently performed for evaluation of chest disease in both adults and children. Children are more exposed to the adverse effects of radiation as compared to adults. During our daily practice, we noticed that most of children’s chest X-ray results were normal. Purpose: This study aimed to evaluate the indications, the technic, the irradiation and the result of chest X-rays in children in order to know if the practice of these X-rays was relevant. Method: Cross-sectional and descriptive study conducted at the Imaging Regional Center of Ngaoundere from April to August 2017. A total number of 145 radiographs and 140 X-ray requests of 140 children were considered in this work. The conformity of the request were verified according to the recommendations of the National Agency for Accreditation and Health Evaluation in France (NAAHE), technical condition of realization and results were appreciated and the entrance surface dose (ESD) of the patients was estimated using a mathematical algorithm. Results: Children under 5 years (63.5%) were more represented in our study. The main indications were: cough (22.1%), suspicion of pneumonia (16.4%) and bronchitis (15.7%). No indication was mentioned on 69.3% of the request forms. After confrontation to the “Guide for proper use of medical imaging examinations” (GPU), we only had 24% conformity of indications. 82.7% of the examinations required immobilization assistance by the parents. Most of the children were imaged in a standing-up position (82.9%) and the anterior-posterior view (77.9%) was more practiced. After the analysis of the pictures, 62% of them presented an optimal contrast, while 42.1% of X-ray were performed without beam collimation. 25 X-rays were repeated: 12 (48%) because of patient’s motion and 13 (52%) of mispositionning. After interpretation, 87 (62.14%) chest X-ray were normal. Main lesion observed were pneumonia (17.14%) followed by bronchopeumopathy (5.71%) and bronchitis (5%). The obtained ESD values were 0.11, 0.15 and 0.17 mGy respectively for the 0 - 1 year, 1 - 5 year and 5 - 10 year age groups;0.2 and 0.57 respectively for postero-anterior (PA) and lateral (LAT) view for the age group 10 - 15 years, which were slightly greater than the values in internationally published studies. Conclusion: The request for children chest X-ray is not relevant in terms of indication, technical conditions of realization and irradiation.
文摘Idiopathic pneumomediastinum is rare in children. Few cases of patients with pneumomediastinum show negative findings on X-ray examination. Chest computed tomography (CT) was very useful for the diagnosis and evaluation of the extent of pneumomediastinum. We report here a case of idiopathic pneumomediastinum in a 15-year-old boy who exhibited no significant chest X-ray finding. The patient was referred to our institute for the further evaluation of pre-cordial pain and breathing difficulty. Precordial pain suddenly developed, when he was carrying a portable shrine on his shoulder (day of onset). He was admitted to another institute 3 days after onset because of worsening precordial pain. On admission, he presented with 98% saturation of hemoglobin in the peripheral blood under room air. Plain chest X-ray also revealed no abnormal findings. A half-dissolved gastrographin swallow showed no leakage of gastrographin from the pharynx and esophagus to the mediastinum, and no diverticulum within the esophagus. Plain chest CT revealed extensive emphysema around the trachea from the neck to the portion inferior to the carina of trachea. The patient was diagnosed with idiopathic pneumomediastinum because the cause was unclear. We decided to admit him to our institute under fasting conditions and rest. His symptoms improved 3 days after onset. The lesion had disap-peared 8 days after onset on chest CT. When young people experience precordial pain which increases on inspiration, we must consider pneumomediastinum in a differential diagnosis, and it is important to perform chest CT.
文摘BACKGROUND:The appropriate sequence of different imagings and indications of thoracic computed tomography(TCT)in evaluating chest trauma have not yet been clarified at present.The current study was undertaken to determine the value of chest X-ray(CXR)in detecting chest injuries in patients with blunt trauma.METHODS:A total of 447 patients with blunt thoracic trauma who had been admitted to the emergency department(ED)in the period of 2009–2013 were retrospectively reviewed.The patients met inclusion criteria(age>8 years,blunt injury to the chest,hemodynamically stable,and neurologically intact)and underwent both TCT and upright CXR in the ED.Radiological imagings were re-interpreted after they were collected from the hospital database by two skilled radiologists.RESULTS:Of the 447 patients,309(69.1%)were male.The mean age of the 447 patients was 39.5±19.2(range 9 and 87 years).158(35.3%)patients were injured in motor vehicle accidents(MVA).CXR showed the highest sensitivity in detecting clavicle fractures[95%CI 78.3(63.6–89)]but the lowest in pneuomediastinum[95%CI 11.8(1.5–36.4)].The specificity of CXR was close to 100%in detecting a wide array of entities.CONCLUSION:CXR remains to be the first choice in hemodynamically unstable patients with blunt chest trauma.Moreover,stable patients with normal CXR are candidates who should undergo TCT if significant injury has not been ruled out.
文摘Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French National Authority for Health in prescribing chest radiography. Methodology: We conducted a retrospective analysis study, in two radiology centers belonging to the same group in Saint-Omer and Aire-sur-la-Lys, of requests for chest radiography sent by general practitioners over the winter period between December 22, 2013, and March 21, 2014, for patients aged over 18 years. Results: One hundred and seventy-seven requests for chest X-rays were analyzed, 71.75% of which complied with recommendations. The most frequent reason was the search for bronchopulmonary infection, accounting for 70.08% of prescriptions, followed by 11.2% for requests to rule out pulmonary neoplasia, whereas the latter reason did not comply with recommendations. Chest X-rays contributed to a positive diagnosis in 28.81% of cases. The positive diagnosis was given by 36.22% of the recommended chest X-rays, versus 10% for those not recommended. Conclusion: In most cases, general practitioners follow HAS recommendations for prescribing chest X-rays. Non-recommended chest X-rays do not appear to make a major contribution to diagnosis or patient management, confirming the value of following the recommendations of the French National Authority for Health.
文摘<strong>Objective:</strong> To investigate the time course and findings severity of COVID-19 infection at chest radiography based on a 6-point radiological severity score, and correlates these with patients’ age and gender. <strong>Methods:</strong> This is a retrospective study of COVID-19 patients who were admitted at European Gaza Hospital and evaluated between October 6, 2020, and November 30, 2020. Baseline and serial chest radiographs, up to 4 images per patient, were reviewed and assessed for predominant pattern, side, and location of lung opacity. Utilized a 6-point scoring system, which divides the chest X-ray into 6 zones, to assess chest X-ray changes and correlate them with the severity of infection, age, and gender of patients. <strong>Results</strong><strong>:</strong> The study included 136 COVID-19 patients: (51/136, 37%) were males and (85/136, 62.5%) were females, while age ranged from 7 months to 90 years with a mean age of 41.7 ± (19.5) years. Negative Chest x-rays were more observed than positive images. Ground-glass opacity was the most frequent pattern with a decreasing trend from 1st to 4th chest X-ray (from 33.8% to 3.7%), followed by consolidation (from 16.2% to 2.9%). Also, the commonest pattern of opacity was seen in peripheral areas (27/136, 19.9%), lower zone location (23/136, 16.9%), and bilateral opacity involvement (43/136;31.6%). No significant correlation was noticed between the patient’s gender, age, and severity score (P > 0.05). <strong>Conclusions</strong><strong>: </strong>The 6-point chest X-ray severity score as a predictive tool in assessing the severity due to provide an assessment of the progression or regression pathway.
文摘<span style="font-family:Verdana;">Detecting and segmenting the lung regions in chest X-ray images is an important part in artificial intelligence-based computer-aided diagnosis/detection (AI-CAD) systems for chest radiography. However, if the chest X-ray images themselves are used as training data for the AI-CAD system, the system might learn the irrelevant image-based information resulting in the decrease of system’s performance. In this study, we propose a lung region segmentation method that can automatically remove the shoulder and scapula regions, mediastinum, and diaphragm regions in advance from various chest X-ray images to be used as learning data. The proposed method consists of three main steps. First, employ the simple linear iterative clustering algorithm, the lazy snapping technique and local entropy filter to generate an entropy map. Second, apply morphological operations to the entropy map to obtain a lung mask. Third, perform automated segmentation of the lung field using the obtained mask. A total of 30 images were used for the experiments. In order to verify the effectiveness of the proposed method, two other texture maps, namely, the maps created from the standard deviation filtering and the range filtering, were used for comparison. As a result, the proposed method using the entropy map was able to appropriately remove the unnecessary regions. In addition, this method was able to remove the markers present in the image, but the other two methods could not. The experimental results have revealed that our proposed method is a highly generalizable and useful algorithm. We believe that this method might act an important role to enhance the performance of AI-CAD systems for chest X-ray images.</span>