OBJECTIVETo develop a percutaneous and transpedical interbody bone grafting apparatus for vertebral bone defect reconstruction in thoracolumbar fracture correction via minimally invasive operation.

METHODSThe percutaneous and transpedical interbody bone grafting apparatus was designed with CAD software, and the reduction effect, range of bone grafting and surgical complications of the apparatus were investigated in adult cadaveric thoracolumbar body and with computerized surgical simulation.

RESULTSThe self-designed apparatus was convenient for percutaneous and transpedical interbody bone grafting that did not give rise to complications. CT showed large bone grafting area with increased density in the vertebral body corrected with this apparatus.

CONCLUSIONThe designed apparatus allows easy manipulation and efficient bone grafting and repositioning. Minimally invasive interbody bone grafting in thoracolumbar fracture can be easily performed with proper application of the apparatus.

Bone Transplantation ; instrumentation ; Equipment Design ; Humans ; Radiography ; Reconstructive Surgical Procedures ; instrumentation ; Thoracic Vertebrae ; diagnostic imaging ; surgery

OBJECTIVETo explore the image quality of different tube voltage on digital chest radiograph for contrast detail phantom (CDRAD2.0) and occupational exposed workers.

METHODSThe CDRAD2.0 phantom DR images of high KV and different tube voltages were analyzed by 3 readers, image quality figure (IQF) were calculated and compared; at the same time 136 exposed workers were examined with high-kV and DR chest radiograph of different tube voltages. Contrast to high-KV images, 10 anatomic sites were scored .The image differences were compared between DR and high-kV.

RESULTSOn CDRAD2.0 phantom, the IQF value of DR images in 3 readers were minimum in the condition of 120 kV, average value was 22.25. The analysis of variance in model with random effects, the mean IQF value of different tube voltage DR image had a significant difference (F = 13.775, P<0.01); By Dunnett t-tests analysis, the mean IQF value of DR image in 120 kV and high kilovoltage had no difference (t = -0.58, P = 0.979); On clinical cases, the DR image of 120 kV showed the closest anatomy to the high KV, the mean had no significant difference with 0 (P > 0.05) with single sample t test.

CONCLUSIONOn the CDRAD2.0 phantom or clinical exposed workers, the DR image quality of 120 kV tube voltage equals to high-KV basically.

Adult ; Aged ; Dust ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Radiographic Image Enhancement ; instrumentation ; methods ; Radiography, Thoracic ; instrumentation ; methods

Deep Learning ; Diagnosis, Computer-Assisted ; Humans ; Pneumoconiosis/diagnosis* ; Radiography, Thoracic/instrumentation*

Coronary stent dislodgement is a rare complication of percutaneous coronary intervention. We report a case of stent dislodgement in the ascending thoracic aorta. The stent was mechanically distorted in the left circumflex artery (LCX) while being delivered to the proximal LCX lesion. The balloon catheter was withdrawn, but the stent with the guide wire was remained in the ascending thoracic aorta. The stent was unable to be retrieved into the guide catheter, as it was distorted. A goose neck snare was used successfully to catch the stent in the ascending thoracic aorta and retrieved the stent externally via the arterial sheath.
Angioplasty, Balloon, Coronary/*adverse effects/*instrumentation ; *Aorta, Thoracic/radiography ; Cardiac Catheterization/*adverse effects/*instrumentation ; Coronary Angiography ; Device Removal/*instrumentation ; Foreign Bodies/etiology/radiography/*therapy ; Humans ; Male ; Middle Aged ; Radiography, Interventional ; *Stents ; Treatment Outcome

OBJECTIVE: To compare the diagnostic performance of light emitting diode (LED) backlight monitors and cold cathode fluorescent lamp (CCFL) monitors for the interpretation of digital chest radiographs. MATERIALS AND METHODS: We selected 130 chest radiographs from health screening patients. The soft copy image data were randomly sorted and displayed on a 3.5 M LED (2560 x 1440 pixels) monitor and a 3 M CCFL (2048 x 1536 pixels) monitor. Eight radiologists rated their confidence in detecting nodules and abnormal interstitial lung markings (ILD). Low dose chest CT images were used as a reference standard. The performance of the monitor systems was assessed by analyzing 2080 observations and comparing them by multi-reader, multi-case receiver operating characteristic analysis. The observers reported visual fatigue and a sense of heat. Radiant heat and brightness of the monitors were measured. RESULTS: Measured brightness was 291 cd/m2 for the LED and 354 cd/m2 for the CCFL monitor. Area under curves for nodule detection were 0.721 +/- 0.072 and 0.764 +/- 0.098 for LED and CCFL (p = 0.173), whereas those for ILD were 0.871 +/- 0.073 and 0.844 +/- 0.068 (p = 0.145), respectively. There were no significant differences in interpretation time (p = 0.446) or fatigue score (p = 0.102) between the two monitors. Sense of heat was lower for the LED monitor (p = 0.024). The temperature elevation was 6.7degrees C for LED and 12.4degrees C for the CCFL monitor. CONCLUSION: Although the LED monitor had lower maximum brightness compared with the CCFL monitor, soft copy reading of the digital chest radiographs on LED and CCFL showed no difference in terms of diagnostic performance. In addition, LED emitted less heat.
Cold Temperature ; Data Display ; *Electrodes ; Equipment Design ; Humans ; *Image Interpretation, Computer-Assisted ; Lung Neoplasms/*radiography ; ROC Curve ; Radiographic Image Enhancement/*instrumentation ; Radiography, Thoracic/*instrumentation ; Retrospective Studies ; Tomography, X-Ray Computed/*instrumentation

Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications.
Biopsy, Needle/instrumentation/*methods ; Contrast Media/diagnostic use ; Equipment Design ; Fluoroscopy ; Humans ; Lung Diseases/*pathology/radiography ; Mediastinal Diseases/*pathology/radiography ; Patient Positioning ; Radiography, Interventional/*methods ; Radiography, Thoracic/*methods ; *Tomography, X-Ray Computed

OBJECTIVETo evaluate the feasibility of the pedicle screw pilot holes placement in thoracic spine using the spiral wires as the guide pin.

METHODSThe pedicle screw pilot holes were drilled within the center of the pedicle and the lateral and medial pedicle walls were violated in 9 human dried thoracic vertebrae. Kirschner wires or spiral wires were separately placed in the holes, and then the posteroanterior and lateral radiographs were taken. The radiographs were evaluated by 3 experienced spine surgeons and 3 young orthopedists. After radiographs were shown to these observers, they combined the posteroanterior and lateral radiographs in each place and determined whether the pedicle screw pilot hole violated the pedicle cortex or not. The results were analyzed by a statistical software.

RESULTSSensitivity, specificity and accuracy of the method using spiral wires to detect pedicle pilot hole placement were significantly higher than those of using Kirschner wires. With a true posteroanterior radiograph, the sensitivity, specificity and accuracy of the method using spiral wires approximated or attained 100%.

CONCLUSIONSThe method of intrapedicular pilot hole placement verification using spiral wires is effective for guiding the accurate placement of pedicle screws.

Bone Screws ; Bone Wires ; Cadaver ; Feasibility Studies ; Humans ; Internal Fixators ; Predictive Value of Tests ; Radiography ; Reproducibility of Results ; Sensitivity and Specificity ; Spinal Fusion ; instrumentation ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Treatment Outcome

Adult ; Angiography ; Catheterization, Swan-Ganz ; instrumentation ; Device Removal ; adverse effects ; methods ; Diagnosis, Differential ; Equipment Failure ; Foreign-Body Migration ; diagnostic imaging ; etiology ; surgery ; Heart Atria ; injuries ; Humans ; Male ; Radiography, Thoracic ; Thoracic Surgical Procedures ; methods

PURPOSE: We performed 65 cases of posterior fusion surgery for cervical and/or high thoracic lesions using a polyaxial screw-rod system. PATIENTS AND METHODS: A total of 486 screws were implanted in 65 patients. RESULTS: Fixation of the screws was carried out over an average of 2.9 spinal segments. Upon evaluation by postoperative CT scans, twelve (2.5%) screws had suboptimal trajectories but two of these revealed radiculopathy in one patient and required screw repositioning. No vascular sequelae resulted. There has been no segmental motion in any of the cases to date. As for other complications, there was one case of dural tearing and two cases of lateral mass fractures. There were no infections or other wound healing problems or hardware failures. No patients had neurological deterioration after surgery. There were statistically significant improvements in the mean Neck Disability Index (NDI) scores and Visual Analogue Scale (VAS) scores in the preoperative and late postoperative follow-up evaluations. Although further studies are required to establish the long-term results of fusion rates and clinical outcomes. CONCLUSION: We cautiously suggest that the posterior polyaxial screw-rod system can be safely used as a primary or additional fusion method in this risky region. The successful and safe use of this method is dependent on a precise preoperative surgical plan and tactics for ensuring safe screw fixation.
Adult ; Aged ; Aged, 80 and over ; *Bone Screws ; Cervical Vertebrae/radiography/*surgery ; Female ; Humans ; Male ; Middle Aged ; Recovery of Function ; Reproducibility of Results ; Spinal Diseases/physiopathology/*surgery ; Spinal Fusion/instrumentation/*methods ; Thoracic Vertebrae/radiography/surgery ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVE: To evaluate the effect of computer-aided detection (CAD) system on observer performance in the detection of malignant lung nodules on chest radiograph. MATERIALS AND METHODS: Two hundred chest radiographs (100 normal and 100 abnormal with malignant solitary lung nodules) were evaluated. With CT and histological confirmation serving as a reference, the mean nodule size was 15.4 mm (range, 7-20 mm). Five chest radiologists and five radiology residents independently interpreted both the original radiographs and CAD output images using the sequential testing method. The performances of the observers for the detection of malignant nodules with and without CAD were compared using the jackknife free-response receiver operating characteristic analysis. RESULTS: Fifty-nine nodules were detected by the CAD system with a false positive rate of 1.9 nodules per case. The detection of malignant lung nodules significantly increased from 0.90 to 0.92 for a group of observers, excluding one first-year resident (p = 0.04). When lowering the confidence score was not allowed, the average figure of merit also increased from 0.90 to 0.91 (p = 0.04) for all observers after a CAD review. On average, the sensitivities with and without CAD were 87% and 84%, respectively; the false positive rates per case with and without CAD were 0.19 and 0.17, respectively. The number of additional malignancies detected following true positive CAD marks ranged from zero to seven for the various observers. CONCLUSION: The CAD system may help improve observer performance in detecting malignant lung nodules on chest radiographs and contribute to a decrease in missed lung cancer.
Aged ; Algorithms ; Diagnosis, Computer-Assisted/*instrumentation ; Diagnosis, Differential ; Female ; Humans ; Image Interpretation, Computer-Assisted ; Lung Neoplasms/*radiography ; Male ; Middle Aged ; Observer Variation ; ROC Curve ; *Radiography, Thoracic ; Reproducibility of Results ; Tomography, X-Ray Computed