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Chest Radiography: General Practitioners’ Compliance with Recommendations

Open Journal of Medical Imaging 2024年第2期14卷 56-63页

作者： Milckisédek Judicaël Marouruana Some Aïda Ida Tankoano Pakisba Ali Ouedraogo Bassirou Kindo Nina-Astrid Ouedraogo Mohammed Ali Harchaoui department of Medical Imaging The Ouahigouya Regional University Hospital University of Ouahigouya Ouahigouya Burkina Faso department of Medical Imaging Souro Sanou University Hospital Nazi Boni University Bobo Dioulasso Burkina Faso department of Medical Imaging Bogodogo University Hospital Joseph Ki Zerbo University Ouagadougou Burkina Faso Private radiologist Lille France

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.

关键词： Chest X-Ray Recommendations General Practitioners Prescription

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Abdominal cocoon syndrome-a rare culprit behind small bowel ischemia and obstruction:Three case reports

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 955-965页

作者： Witcha Vipudhamorn Tawan Juthasilaparut Pawit Sutharat Suwan Sanmee Ekkarin Supatrakul department of Colorectal Surgery Chiang Mai UniversityChiang Mai 50200Thailand department of Surgery Lampang HospitalLampang 52000Thailand

BACKGROUND Abdominal cocoon syndrome(ACS)represents a category within sclerosing encapsulating peritonitis,characterized by the encapsulation of internal organs with a fibrous,cocoon-like membrane of unknown origin,resulting in bowel obstruction and *** this condition before surgery poses a cha-llenge,often requiring confirmation during *** this context,we depict three instances of ACS:One linked to intestinal obstruction,the second exclu-sively manifesting as intestinal ischemia without any obstruction,and the final case involving a discrepancy between the radiologist and the *** SUMMARY Three male patients,aged 53,58,and 61 originating from Northern Thailand,arrived at our medical facility complaining of abdominal pain without any prior *** vital signs remained stable during the *** diagnosis of abdominal cocoon was confirmed through abdominal computed tomography(CT)before *** the first case,the CT scan revealed capsules around the small bowel loops,showing no enhancement,along with mesenteric congestion affecting both small and large bowel loops,without a clear *** second case showed intestinal obstruction due to an encapsulated capsule on the CT *** the final case,a patient presented with recurring abdominal ***,the radiologist suspected enteritis as the cause after the CT ***,a detailed review led the surgeon to suspect encapsulating peritoneal sclerosis(ACS)and subsequently perform *** surgical procedure involved complete removal of the encapsulating structure,resection of a portion of the small bowel,and end-to-end *** complications occurred during surgery,and the patients had a smooth recovery after surgery,eventually discharged in good *** histopathological examination of the fibrous membrane(cocoon)across all cases consistently revealed the presence of fibro-collagenous tissue,without any indications of *** Indivi

关键词： Sclerosing encapsulation peritonitis Abdominal cocoon Peritoneal Fibrosis Peritoneal encapsulation syndrome Intestinal obstruction Surgery Case report

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Idiopathic mesenteric phlebosclerosis missed by a radiologist at initial diagnosis: A case report

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World Journal of Clinical Cases 2024年第10期12卷 1810-1816页

作者： Min Wang Yu-Xia Wan Jin-Wen Liao Fei Xiong department of Gastroenterology Changning County People’s HospitalYibin 644300Sichuan ProvinceChina department of Gastroenterology Qianwei People’s HospitalLeshan 614400Sichuan ProvinceChina department of Gastroenterology The People’s Hospital of Jianyang CityChengdu 641400Sichuan ProvinceChina department of Gastroenterology Sichuan Provincial People’s HospitalUniversity of Electronic Science and Technology of ChinaChengdu 610000Sichuan ProvinceChina

BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare type of ischemic colitis characterized by thickening of the wall of the right hemicolon and calcification,sclerosis,and fibrosis of mesenteric *** diagnosis of IMP is based on typical clinical features and imaging *** report a case of IMP that was initially missed by the *** SUMMARY A 77-year-old woman was admitted to the hospital due to chronic diarrhea for over 2 *** had been consuming Chinese patent medicines(CPM)containing fructus gardeniae for more than 15 *** revealed an edematous mucosa,bluish-purple discoloration,erosions,and ulcerations throughout the colorectal *** computed tomography(CT)showed diffuse mural thickening of the entire colorectum,with tortuous thread-like calcifications in the right hemicolon,left hemicolon,and *** of the calcifications were located in the mesenteric *** diagnosis of IMP was established based on medical history,colonoscopy,CT findings,and histopathological *** patient was treated conservatively with papaverine and rifaximin,and CPM was *** diarrhea symptoms improved,indicating the effectiveness of the *** the next several years,she took opium alkaloids for an extended period and did not require hospitalization for the aforementioned gastrointestinal *** IMP is a rare gastrointestinal disease affecting Asian populations,possibly related to long-term herbal medicine *** imaging analysis is crucial for diagnosis,but insufficient understanding of the disease can lead to misdiagnosis or missed *** strategies should be personalized.

关键词： Idiopathic mesenteric phlebosclerosis Computed tomography Colonoscopy Chinese patent medicines Fructus gardeniae Case report

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Correlation of Hamstring Tendon Size in Pre-Operative MRI Measurement with Intra-Operative Graft Size in Primary Anterior Cruciate Ligament (ACL) Reconstruction

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Journal of Biosciences and Medicines 2024年第3期12卷 150-158页

作者： Nurhanani Abu Bakar Mohamad Razip Sirat Hairiah Abas Saiful Safuan Md Sani department of Orthopaedic Hospital Pakar Sultanah Fatimah Muar Malaysia department of Orthopaedic Hospital Tengku Ampuan Rahimah Klang Malaysia department of Radiology Hospital Pakar Sultanah Fatimah Muar Malaysia department of Medicine Clinical Research Center Hospital Kuala Lumpur Kuala Lumpur Malaysia

Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation of pre-operative MRI measurement of Hamstring tendons with the intra-operative ACL graft. Thus, it may help surgeons to anticipate the needs for graft augmentation should the final graft size be smaller than expected. Methods: We retrospectively re-viewed 41 cases of ACL reconstructions in which MRI were done pre-operatively, in Hospital Pakar Sultanah Fatimah (HPSF), Muar between January 2019 until December 2022. MRI measurements of Hamstring tendon (semitendinosus: ST, and gracilis) were done by a radiologist, and the in-tra-operative notes were reviewed for the final graft size. Pearson’s correlation coefficients were calculated to determine the relationship between graft size and tendon cross-sectional area. The intraclass correlation (ICC) by using two-way mixed model with type consistency, the reliability based on average measure was 0.41 (95% CI: ?0.10, 0.69). A p-value < 0.05 was considered sig-nificant. Results: Of 105 patients with primary ACL reconstruction done be-tween January 2019 to December 2022, only 41 patients were included in this study. There was fair correlation (p = 0.048) between pre-operative MRI measurement and the graft diameter intra-operatively. The mean of 17.0 mm of combined diameter of ST and gracilis tendon in MRI may results in graft diameter of 8.3 mm. There was also positive correlation between patients’ height and the intra-operative graft size. Conclusion: These results showed good correlation between pre-operative MRI measurement of Hamstring ten-don size with the intra-operative graft size, hence it is a reliable tool to predict the Hamstring autograft size in ACL reconstruction.

关键词： ACL Reconstruction Pre-Operative MRI Hamstring Tendon

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Comparison of efficacy of lung ultrasound and chest X-ray in diagnosing pulmonary edema and pleural effusion in ICU patients: A single centre, prospective, observational study

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Open Journal of Anesthesiology 2024年第3期14卷 41-50页

作者： Kunal Tewari Sumanth Pelluru Deepak Mishra Nitin Pahuja Akash Ray Mohapatra Jyotsna Sharma Om Bahadur Thapa Manjot Multani department of Anesthesiology and Critical Care Armed Forces Medical College Pune India department of Anesthesiology and Critical Care Military Hospital Bhopal India

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.

关键词： Chest X ray (CXR) Consolidation Pulmonary edema Pleural effusion Lung ultrasound (LUS) Pneumothorax

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Ultrasomics in liver cancer: Developing a radiomics model for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma using contrast-enhanced ultrasound

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World Journal of Radiology 2024年第7期16卷 247-255页

作者： Li-Ya Su Ming Xu Yan-Lin Chen Man-Xia Lin Xiao-Yan Xie department of Medical Ultrasound The First Affiliated HospitalInstitute of Diagnostic and Interventional UltrasoundSun Yat-Sen UniversityGuangzhou 510000Guangdong ProvinceChina

BACKGROUND Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)represent the predominant histological types of primary liver cancer,comprising over 99%of *** their differing biological behaviors,prognoses,and treatment strategies,accurately differentiating between HCC and ICC is crucial for effective clinical ***,an emerging image processing technology,can automatically extract various quantitative image features that may elude the human *** on the application of ultrasound(US)-based radiomics methods in distinguishing HCC from ICC are *** In our retrospective study,we included a total of 280 patients who were diagnosed with ICC(n=140)and HCC(n=140)between 1999 and *** patients were divided into training(n=224)and testing(n=56)groups for *** images and relevant clinical characteristics were *** utilized the XGBoost method to extract and select radiomics features and further employed a random forest algorithm to establish ultrasomics *** compared the diagnostic performances of these ultrasomics models with that of *** Four distinct ultrasomics models were constructed,with the number of selected features varying between models:13 features for the US model;15 for the contrast-enhanced ultrasound(CEUS)model;13 for the combined US+CEUS model;and 21 for the US+CEUS+clinical data *** US+CEUS+clinical data model yielded the highest area under the receiver operating characteristic curve(AUC)among all models,achieving an AUC of 0.973 in the validation cohort and 0.971 in the test *** performance exceeded even the most experienced radiologist(AUC=0.964).The AUC for the US+CEUS model(training cohort AUC=0.964,test cohort AUC=0.955)was significantly higher than that of the US model alone(training cohort AUC=0.822,test cohort AUC=0.816).This finding underscored the significant benefit of incorporating CEUS information in accurately distin-guishing ICC from HC

关键词： Cholangiocarcinoma Hepatocellular carcinoma Contrast-enhanced ultrasound Radiomics Primary liver tumor

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Comparison of Transvaginal Ultrasound, Saline Infusion Sonohysterography versus Diagnostic Hysteroscopy in Evaluation of Endometrial Cavity Pathology amongst Women with Abnormal Uterine Bleeding in Low Resource Setting

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Open Journal of Obstetrics and Gynecology 2020年第5期10卷 644-656页

作者： Jayni Dedhia Gichuhi J.Wanyoike Ojwang B.Shadrack Madadi M.Obimbo Rafique B.Parkar Elijah Kwasa department of Obstetrics&Gynaecology University of NairobiNairobiKenya department of Anatomy University of NairobiNairobiKenya Consultant Obstetrician&Gynecologist NairobiKenya Consultant radiologist NairobiKenya

Introduction: Hysteroscopy is currently the gold-standard protocol for evaluating patients with abnormal uterine bleeding (AUB). Unfortunately, though accurate, its adoption in low-resource countries such as in Africa is limited due to lack of equipment and qualified personnel. As such, there is a need for an alternative diagnostic procedure that is as accurate as hysteroscopy, but also affordable, easy to administer, and acceptable by women with endometrial pathologies. Transvaginal Sonography (TVS) and Saline Infusion Sonohysterography (SIS) are proposed. However, their diagnostic accuracy versus hysteroscopy has not been determined in low resource setting. Objective: To compare the diagnostic efficacy of TVS and SIS versus diagnostic hysteroscopy in evaluation of endometrial pathology among pre-menopausal and post-menopausal women and to determine the etiology of AUB amongst these women. Methodology: A prospective cohort study was done at a hospital in Nairobi, Kenya between May and September 2019. Forty patients with AUB were recruited using consecutive sampling, and women who consented were recruited. The etiology of AUB was recorded. All participants underwent TVS, SIS and Diagnostic Hysteroscopy (DH) evaluation in the first half of the menstrual cycle and the findings recorded on a patient’s information sheet. The sociodemographic and bleeding characteristics of patients and the outcomes of TVS, SIS, and DH evaluations were also recorded and the data was analysed using version 5 of the Software for Statistics and Data Science (STATA). Summary statistics on the etiology of AUB were presented and the sensitivity of TVS and SIS versus DH as the gold-standard evaluated using two by two tables and the ROC curve. Results: The mean age of participants was 38.1 ± 8.8 years, range of 25 - 71 years. Heavy Menstrual Bleeding (HMB) was reported in 70.0% of participants, while about 12.0%, 7.5%, and 7.5% had post-menopausal bleeding, amenorrhea, and hypomenorrhea. The inc

关键词： Abnormal Uterine Bleeding Transvaginal Sonography Saline Infusion Sonohysterography Hysteroscopy

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Radiology education in Europe: Analysis of results from 22 European countries

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World Journal of Radiology 2017年第2期9卷 55-62页

作者： Bhavya Rehani Yi C Zhang Madan M Rehani András Palkó Lawrence Lau Miriam N Mikhail Lette William P Dillon department of Radiology and Biomedical Imaging University of California department of Radiology Massachusetts General Hospital Harvard Medical School department of Radiology University of Szeged Consultant Diagnostic radiologist RAD-AID International

AIM To assess the state of radiology education across Europe by means of a survey *** A comprehensive 23-item radiology survey was distributed via email to the International Society of Radiology members, national radiological societies, radiologists and medical physicists. Reminders to complete the survey were sent and the results were analyzed over a period of 4 mo(Jan-April 2016). Survey questions include length of medical school and residency training; availabilityof fellowship and subspecialty training; number of residency programs in each country; accreditation pathways; research training; and medical physics education. Descriptive statistics were used to analyze and summarize *** Radiology residency training ranges from 2-6 years with a median of 5 years, and follows 1 year of internship training in 55%(12 out of 22) European countries. Subspecialty fellowship training is offered in 55%(12 out of 22) European countries. Availability for specialization training by national societies is limited to eight countries. For nearly all respondents, less than fifty percent of radiologists travel abroad for specialization. Nine of 22(41%) European countries have research requirements during residency. The types of certifying exam show variation where 64%(14 out of 22) European countries require both written and oral boards, 23%(5 out of 22) require oral examinations only, and 5%(1 out of 22) require written examinations only. A degree in medical physics is offered in 59%(13 out of 22) European countries and is predominantly taught by medical physicists. Nearly all respondents report that formal examinations in medical physics are *** Comparative learning experiences across the continent will help guide the development of comprehensive yet pragmatic infrastructures for radiology education and collaborations in radiology education worldwide.

关键词：辐射学教育欧洲辐射学调查辐射学训练住处辐射学研究

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Bariatric Surgery Impact on Sickle Cell Disease Pain Crisis: A Case Report

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Case Reports in Clinical Medicine 2020年第6期9卷 158-164页

作者： Hassan Al-Jafar Masouma Al-Ali Osama R. Kombar Mohammad Alhaifi Hematology department Amiri Hospital Kuwait City Kuwait Liver & Gastroenterology department Amiri Hospital Kuwait City Kuwait radiologist department Amiri Hospital Kuwait City Kuwait Surgery department Amiri Hospital Kuwait City Kuwait

Sickle cell disease (SCD) is an autosomal genetic blood disorder resulting in multiple end-organ complications. Malnutrition is a stress factor that can cause a SCD crisis. Bariatric surgery is a weight reduction surgery that involves the binding or removing a part of the stomach or resecting and re-routing the small intestine to a small stomach pouch. It is known to cause malnutrition and stress. Malnutrition affects more than two billion people of all ages worldwide due to different causes. Long-term deficiency of micronutrients leads to reduced immunity, leukopenia, and diseases affecting the psychological, skeletal, and central nervous system. We here present the case of a 20-year-old woman with SCD and class III obesity. She underwent sleeve gastrectomy in 2018 following psychological distress caused by being severely overweight. She had mild SCD pain, but after the bariatric surgery, it became severe, requiring morphine treatment and monthly exchange transfusion beside the NSAID which become not much effective as before bariatric surgery. Our findings show that bariatric surgery, which leads to a stressful condition, can aggravate the SCD pain crisis, thereby highlighting the need for alternative methods of weight reduction in these patients. Controlled studies are required for the proper assessment of bariatric surgery in SCD.

关键词： Sickle Cell Disease Bariatric Surgery Pain Crisis

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肺栓塞的影像应用螺旋CT的新观

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英国医学杂志中文版 1998年第1期1卷 6-8页

作者： David M Hansell Christopher D R Flower 邢军 Consultant radiologist department of Radiology Royal Brompton Hospital London SW3 6NP Consultant radiologist department of Radiology Addenbroke's Hospital Cambridge CB2 2QQ

肺栓塞是一种生前常被漏诊的疾病。其死亡率取决于诸多因素,未经治疗患者的年死亡率可高达 30%,是应用抗凝药物患者年死亡率(2.5%)的10倍以上。

关键词：肺栓塞年死亡率肺动脉造影抗凝药物肺动脉栓塞肺动脉栓子灌注显像超声检查结果血流图肺血管

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