• Title/Summary/Keyword: 흉부촬영

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The Effect of a Chest CT Scan on the Treatment and Diagnosis of Major Blunt Chest Trauma (흉부 둔상환자에서 흉부전산화단층촬영이 진단과 치료에 미치는 영향)

  • Park, Il-Hwan;Oh, Joong-Hwan;Lee, Chong-Kook
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.226-232
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    • 2009
  • Background: Blunt chest trauma accounts for 90% of all chest traumas in Europe and the United States and this causes 20% of all trauma-related deaths. The major cause of morbidity and mortality after blunt chest trauma is undetected injuries. For this reason, chest computerized tomography has gained popularity for the evaluation of trauma, but it is expensive and it exposes patients to radiation. This study identified the clinical features associated with the diagnosic information obtained on a CT chest scan, as compared with a standard chest X-ray, for patients who sustained blunt trauma to the chest. This study also evaluated the role of a routine computed tomographic (CT) scan for these patients. The patients who had chest computed tomography done after the initial chest x-ray were analyzed separately for the presence of occult injuries. Material and Method: We studied 100 consecutive patients from November 2006 to July 2007: 74 patients after motor vehicle crashes and 26 patients after a fall from a height >2m. Simultaneous with the initial clinical evaluation, an anteroposterior chest radiograph and a helical chest CT scan were obtained for all the patients. The data extracted from the medical record included the vital signs, the interventions and the type and severity of injury (RTS). Result: Among the 100 cases, 79 patients showed at least more than one pathologic sign on their chest radiograph, and 21 patients had a normal chest radiograph. For 17 of the patients who had a normal chest X ray, the CT scan showed multiple injuries, which were pneumothorax, hemothorax, lung contusion, sternal fracture etc. This represents that a CT scan is statistically superior to a chest radiograph to diagnose the pathologic signs. But on the other hand, as for treatment, only 31 patients were diagnosed by CT scan and they were treated with chest tube insertion ect. 42 patients needed ony conservative management without invasive thoracosurgical treatment such as chest tube insertion or open thoracotomy. 27 patients were treated based on the diagnosis made by the chest radiograph and physical examination. Conclusion: Chest computerized tomography was significantly more effective than routine chest X-ray for detecting lung contusion, pneumothorax and mediastinal hematoma, as well as fractured ribs, scapula and, sternum. Although the occult findings increased, the number of patients who needed treatment was small. Therefore, we suggest making selective use of a CT scan to avoid its overuse in ERs.

The efficacy of computerized tomographic scan for chest trauma (흉부외상 환자에 대한 전산화 단층촬영의 효용성)

  • Roh, Hwan-Kyu;Choi, Ho;Kim, Young-Jin;Kim, Jung-Tae;Soh, Dong-Moon;Ryu, Han-Young;Lee, Cheol-Joo
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.298-303
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    • 1998
  • Computerized tomography(CT) is an effective technique in the initial evaluation of the abdomen and head following blunt trauma. To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram (CXR) was carried out on 134 patients with blunt trauma on the chest. Among 134 patients, 45 patients had normal initial chest roentgenogram and 24 patients showed normal CT findings. Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (46.2 and 62.9% respectively), whereas 71.4%(45/63) of patients had thoracostomy only by CXR. Although sometimes abused, CT of the thorax is effective in the initial diagnosis.

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Evaluation of Effectiveness of New Design Lead Apron during Pregnant X-ray Chest P-A (임산부 흉부 촬영중 사용할 새로 디자인된 납치마의 효율성 평가)

  • Kim, Hyeonggyun;Kwon, Soonmu;Jung, Hongmoon
    • Journal of the Korean Society of Radiology
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    • v.6 no.6
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    • pp.441-445
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    • 2012
  • X-ray Chest P-A is very important and basic diagnosis examination for pregnant women. For a pregnancy period pregnant women should be treated very carefully not to be exposed to any radiation which might cause harmful damage to women and babies as well. Lead apron is one of the effective methods to protect pregnant women from the X-ray radiation. However, it is difficult to obtain the accurate position of pregnant women during X-ray Chest P-A since conventional lead apron method forces pregnant women to hold the apron by themselves only to make pregnant women very uncomfortable and hard to maintain accurate position during radiation. As a consequence, it is common to get low quality images of X-ray Chest P-A due to the overlap of apex of lung and scapular. In order to fix this problem, we made new design lead apron that allowed pregnant women to be more comfortable to maintain accurate position during X-ray Chest P-A position. Finally, with this new design lead apron, it was possible to get the best optimized images of X-ray Chest P-A of pregnant women by minimizing overlapping apex of lung and scapular.

Radiation Dose using Chest CT for Patients with Pneumoconiosis Complication - Comparison with International Guidelines - (진폐요양환자의 흉부 CT촬영에 사용된 선량 - 국내외 진단 참고 준위와 비교 -)

  • Lee, Won-Jeong
    • Journal of Radiation Protection and Research
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    • v.39 no.4
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    • pp.206-212
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    • 2014
  • We report here on the results of evaluating the radiation doses using chest computed tomography (CT) for patients with pneumoconiosis complication. For the first time, we visited the 17 MIPs to evaluate the dose-length product (DLP, $mGy{\cdot}cm$), CT unit, and protocols of scanning and image reconstruction those is routinely used for treating patients with pneumoconiosis who have complication. All statistical analysis was performed using the Statistical Program for Social Sciences (SPSS ver. 19.0, Chicago, IL, USA). Mean of total DLP was $727.7mGy{\cdot}cm$, ranging from 272.0 to $1228.7mGy{\cdot}cm$. DLP from obtaining parenchymal lung images was significantly reduced than that from obtaining total lung images (555.9 vs. 707.2, p<0.001). Third quartile of total and pre-scanning DLP was 1036.1 and $504.1mGy{\cdot}cm$, respectively. Chest CT radiation doses for patients with pneumoconiosis complication are similar with korean diagnostic reference level as well as international guidelines.

Comparison of Quality Control for Chest Radiography between Special Examination and Medical Institution for Pneumoconiosis (진폐 정밀/요양기관과 요양기관의 흉부 방사선분야 정도관리 비교)

  • Lee, Won-Jeong
    • The Journal of the Korea Contents Association
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    • v.11 no.2
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    • pp.322-330
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    • 2011
  • To compare of quality control for chest radiography between special examination (SEP) and medical institution for pneumoconiosis (MIP). For the first time, we had visited at 33 institutions (SEP; 17 institutions, MIP; 16 institutions) to evaluate the quality control of chest radiography which is used in diagnosis of patients with pneumoconiotic complications. Image quality was rated by two experienced chest radiologists, and evaluated for radiological technique (RT), reading environment (RE) and image quality (IQ) between SEP and MIP according to the guideline published by OSHRI. Generator capacity, used duration and modality of chest radiography equipment were not signigicant difference between SEP and MIP, but there were signigicant difference in tube voltage and grid ratio used for chest radiography except to tube current and exposure time. SEP was statistically significant higher in RT (71.2 vs. 54.5, p=0.015), RE (78.8 vs. 51.5, p=0.007) to MIP, but not significant difference in IQ (64.8 vs. 59.3, p=0.180). For reliable and precisional diagnosis of patients with pneumoconiotic complications, the MIP requires the evaluation and education of quality control for improving chest radiography.

Coarctation of the Aorta Associated with Chronic Thoracic Aortic Aneurysm -A case report - (만성 흉부 대동맥류를 동반한 대동맥 축착증 - 1예 보고 -)

  • 구자홍;김경화;김민호;김공수
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.691-694
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    • 2003
  • A 49-year-old woman had thoracic back pain for several years. Chest CT scan and MRI angiography revealed descending thoracic aortic aneurysm with a maximum diameter of 69 mm. Thoracic aortography showed not only the aortic aneurysm, but also coarctation of descending thoracic aorta at the level of aortic hiatus of the diaphragm. Intercostal artery arising Adamkiewicz artery was found in descending thoracic aortic aneurysm just above the coarctation, The aneurysm with coarctation of the aorta was successfully repaired with prosthetic graft replacement under left atrio-femoral bypass.

A Case of the Pneumopericardium Following Blunt Chest Trauma (흉부둔상에 의한 심막기종: 치험 1예)

  • 김오곤
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.627-629
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    • 2003
  • The pneumopericardium following blunt chest trauma is exceedingly unusual. A patient was admitted to the emergency room after a motorcycle accident. Pneumopericardium and left pneumothorax were not detected on initial chest AP, but they were detected on chest computed tomograpy and resolved completely after chest tube insertion into the left pleural space.

Bacteriological Research for the Contamination of Equipment in Chest Radiography (영상의학과 흉부 엑스선 촬영 기기의 세균 오염도)

  • Choi, Seung Gu;Song, Woon Heung;Kweon, Dae Cheol
    • Journal of radiological science and technology
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    • v.38 no.4
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    • pp.395-401
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    • 2015
  • The purpose is to determine the degree of contamination of the equipment for infection control in chest radiography of the radiology department. We confirmed by chemical and bacterial identification of bacteria of the equipment and established a preventive maintenance plan. Chest X-ray radiography contact area on the instrument patients shoulder, hand, chin, chest lateral radiography patient contact areas with a 70% isopropyl alcohol cotton swab were compared to identify the bacteria before and after sterilization on the patient contact area in the chest radiography equipment of the department. The gram positive Staphylococcus was isolated from side shoots handle before disinfection in the chest radiography equipment. For the final identification of antibiotic tested that it was determined by performing the nobobiocin to the sensitive Staphylococcus epidermidis. Chest radiography equipment before disinfecting the handle side of Staphylococcus epidermidis bacteria were detected using a disinfectant should be to prevent hospital infections.

Study of Lung Cancer Screening in Health Examination (건강검진에서 폐암검진의 대한 연구)

  • You, In Gyu;Lim, Cheong Hwan
    • Proceedings of the Korea Contents Association Conference
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    • 2014.11a
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    • pp.199-200
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    • 2014
  • 저선량 흉부 전산화단층촬영을 이용한 페암의 대한 조기검진 시기도 남녀공통 40세 이상을 시작연령으로 제시하고 있으나 조기검진의 연령확대로 인하여 다양한 연령층에서 시행하고 있다. 이에 본 연구에서는 임상적 증상이 없는 자기결정에 의해 저선량 흉부 전산화단층촬영을 시행한 건강검진 대상자를 대상으로 40세 전후로 구분하여 진단적 효용성과 저선량 흉부 전산화 단층촬영의 대한 바람직한 방향을 제시하고자 한다. 분석한 결과 결절의 개수는 유의하게 나타났으나 방사선 피폭에 대한 전체적인 위해와 이득에 대한 정당성 확보가 이루어지지 않았다. 저선량 흉부 전산화단층촬영 정당성 확보를 위해 흡연력 있는 40대 이상을 시작연령으로 해야 한다.

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The Clinical Value about Pulmonary Tuberculosis of Indirect Chest Radiography in Physical Examination for Conscription (징병 신체 검사시 집단 흉부 간접 방사선 촬영의 폐결핵 관련한 진단적 유용성)

  • Park, Sung Bin;Choi, Byeong-Kyoo;Ha, Keun Woo;Seo, Joon Beom
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.356-360
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    • 2005
  • Background : This study examined the clinical utility of using indirect chest radiography during a physical examination of new conscripts for determine the presence of pulmonary tuberculosis. Methods : Over an eight-month period, this study examined 25386 people who underwent a physical examination after conscription. The abnormal findings on mass miniature radiography were followed-up using direct chest radiography. The positive predictive value of mass miniature radiography and direct chest radiography was compared. The incidence, degree of infiltration and clinical outcome of active pulmonary tuberculosis were also evaluated during a follow-up examination. Results : The positive rate of mass miniature radiography was 1.19% (n=302). Various lesions were identified: Parenchymal lesions (n=109), mediastinal lesions (n=6), cardiovascular lesions (n=45), pleural lesions (n=49), bony lesions (n=90) and miscellaneous lesions (n=7). The incidence of active pulmonary tuberculosis by mass miniature radiography was 0.26% (n=67). The first diagnosis was made in 50 people; active pulmonary tuberculosis (n=42), pneumonia (n=1), a mediastinal mass (n=1), a rib fracture (n=2) and a pneumothorax (n=4). Most cases of active pulmonary tuberculosis were mildly infiltrated and either improved or were cured by the follow-up examination. Conclusion : Although mass miniature radiography in a physical examination after conscription has limitations, but it is a useful means for detecting the presence of early disease, particularly in active pulmonary tuberculosis.