There are various histological characteristics which have been proposed to predict the survival rate in colon cancer.However,there is no definitive model to accurately predict the survival.Therefore,it is important to...There are various histological characteristics which have been proposed to predict the survival rate in colon cancer.However,there is no definitive model to accurately predict the survival.Therefore,it is important to find out one model for the prediction of survival in colon cancer which may also include the preoperative,and operative factors in addition to histopathology.展开更多
Magnetic resonance enterography(MRE)is a non-invasive,radiation-free imaging modality that facilitates the assessment of transmural Crohn’s disease activity.It offers advantages over ileo-colonoscopy,which is limited...Magnetic resonance enterography(MRE)is a non-invasive,radiation-free imaging modality that facilitates the assessment of transmural Crohn’s disease activity.It offers advantages over ileo-colonoscopy,which is limited to mucosal-level evaluation,cannot routinely assess small bowel segments proximal to the terminal ileum,and is unable to detect extra-luminal complications.Despite these ad-vantages,the lack of standardised criteria for defining and appraising radiologic disease activity on MRE has contributed to variability in interpretation and clinical application.In response,multiple MRE-based scoring systems have been developed to quantify radiological Crohn’s disease activity in both luminal and post-operative settings.Radiological disease activity scores specific to luminal Crohn’s disease include the magnetic resonance index of activity(MaRIA),simplified MaRIA,Nancy score,London score,Crohn’s disease magnetic reso-nance imaging(MRI)index,Clermont score,paediatric inflammatory Crohn’s MRE index,MRE global score,MRE index,and modified Clermont score.The MR score and the MRI in Crohn’s disease to predict postoperative recurrence index have been specifically developed to evaluate post-operative disease recurrence in Crohn’s disease.Nevertheless,heterogeneity in scoring parameters,variability in computational complexity,and a lack of consensus regarding optimal score selection,have impeded widespread clinical adoption of radiological disease activity scores.This narrative review aims to summarise the key imaging features of luminal Crohn’s disease,explore their integration into existing MRE scoring indices,and critically compare the structure,strengths,and clinical applicability of each.Furthermore,MRI scores specific to post-operative Crohn’s disease evaluation,and the assessment of cumulative bowel wall damage using the Lemann index will also be discussed.展开更多
Colorectal cancer(CRC)remains one of the leading causes of cancer-related mortality worldwide.Despite advances in early detection and treatment,approximately half of patients with CRC develop liver metastases(LM),comp...Colorectal cancer(CRC)remains one of the leading causes of cancer-related mortality worldwide.Despite advances in early detection and treatment,approximately half of patients with CRC develop liver metastases(LM),complicating therapeutic strategies and reducing survival rates.Radiological imaging is critical in managing colorectal LM by guiding detection,staging,treatment planning,and response evaluation.This letter to the editor provides a comprehensive overview of both traditional and emerging imaging modalities,including computed tomography,magnetic resonance imaging,and positron emission tomography,and their specific roles in clinical decision-making.It further explores advanced techniques such as radiomics,artificial intelligence,and radiogenomics,which integrate quantitative imaging features with genetic and clinical data to enhance prognostication and tailor personalized treatment approaches.Specific examples of how these innovations are applied in treatment response assessment and presurgical planning are highlighted.The discussion also emphasizes the need for large-scale prospective clinical trials and standardized protocols to validate current predictive models and fully integrate these advanced methodologies into clinical practice.展开更多
Gamma-ray spectroscopy based on a 100% efficiency hyper-pure germanium detector was used to evaluate the activity concentrations of <sup>226</sup>Ra, <sup>232</sup>Th, and <sup>40</sup...Gamma-ray spectroscopy based on a 100% efficiency hyper-pure germanium detector was used to evaluate the activity concentrations of <sup>226</sup>Ra, <sup>232</sup>Th, and <sup>40</sup>K natural radionuclides in sedimentary, conglomerate, igneous and sedi-ments rock samples collected from four different locations in Eastern desert in Egypt. The obtained activity concentrations are used to evaluate the radi-ological hazards indices, absorbed dose rate, annual effective dose equivalent in air, radium equivalent, external and internal hazard index, radiation level index, annual gonadal dose equivalent, excess lifetime cancer risk and expo-sure rate. The results show that 1) the absorbed dose rate depends on the rock type, 2) the annual effective dose equivalent in air in 71% of sample below 20 mSvy<sup>-1</sup> (permissible limit for workers), 3) the conglomerate rocks show low radioactivity level, 4) sedimentary rocks are rich in radium while igneous rocks are rich in thorium and the sediments rocks are rich in both radium and thorium.展开更多
Introduction: Radiology and medical imaging examinations bring together the means of acquiring and restoring images of the human body from different physical phenomena such as the absorption of X-rays, nuclear magneti...Introduction: Radiology and medical imaging examinations bring together the means of acquiring and restoring images of the human body from different physical phenomena such as the absorption of X-rays, nuclear magnetic resonance, reflection of ultrasound waves or radioactivity, with which we sometimes associate optical imaging techniques such as endoscopy. The objective of our study was to study the profile of radiological examinations in the radiology and medical imaging department of the “KALALE” medical clinic. Methodology: This was a descriptive, prospective study that took place over a period of six (6) months in the radiology and medical imaging department of the “KALALE” medical clinic and the centers of health of communes III and IV of Bamako in Mali. Data collection was carried out on a survey form. The parameters studied were sociodemographic data, clinical data, radiological data. Results: We recorded 6030 radiology examinations of which 19% of the examination frequency cases came from the “KALALE” medical clinic and 81% of the cases were referrals from the reference health centers of communes III and IV. There were 1500 X-rays or 24.9% of cases including 54% cases of bone X-rays;5% of cases of skull and face X-rays;5% of cases of Intravenous Urography (IVU);4% of cases of Hysterosalpingography (HSG);3% of cases of Retrograde Ureterocystography (UCR) and 1% of cases of X-ray of the Abdomen without preparation (ASP). We found 4530 ultrasounds or 75.1% of cases. Conclusion: Medical imaging has become essential in the study of the human body and now constitutes an essential tool for the detection and treatment of most pathologies, from simple fractures to the most serious tumors.展开更多
Hepatic artery thrombosis(HAT)is a devastating vascular complication following liver transplantation,requiring prompt diagnosis and rapid revascularization treatment to prevent graft loss.At present,imaging modalities...Hepatic artery thrombosis(HAT)is a devastating vascular complication following liver transplantation,requiring prompt diagnosis and rapid revascularization treatment to prevent graft loss.At present,imaging modalities such as ultrasound,computed tomography,and magnetic resonance play crucial roles in diagnosing HAT.Although imaging techniques have improved sensitivity and specificity for HAT diagnosis,they have limitations that hinder the timely diagnosis of this complication.In this sense,the emergence of artificial intelligence(AI)presents a transformative opportunity to address these diagnostic limitations.The development of machine learning algorithms and deep neural networks has demonstrated the potential to enhance the precision diagnosis of liver transplant complications,enabling quicker and more accurate detection of HAT.This article examines the current landscape of imaging diagnostic techniques for HAT and explores the emerging role of AI in addressing future challenges in the diagnosis of HAT after liver transplant.展开更多
Hilar cholangiocarcinoma is a rare malignant tumor arising from the epithelium of the bile ducts.Surgery is still the only chance of potentially curative treatment in patients with perihilar cholangiocarcinoma.However...Hilar cholangiocarcinoma is a rare malignant tumor arising from the epithelium of the bile ducts.Surgery is still the only chance of potentially curative treatment in patients with perihilar cholangiocarcinoma.However,radical resection requires aggressive surgical strategies that should be tailored optimally according to the location,size and vascular invasion of the tumors.Accurate diagnosis and staging of these tumors is therefore critical for optimal treatment planning and for determining a prognosis.Multidetector computed tomography(MDCT),magnetic resonance imaging(MRI) and MR cholangiography are useful tools,both to diagnose and stage hilar cholangiocarcinoma.Modern imaging techniques allow accurate detection of the level of obstruction and the longitudinal and radial spread of the tumor.In addition,high-resolution MDCT and MR provide specific radiographic features to determine vascular involvement of anatomic structures,such as the hepatic artery or the portal vein,which are critical to decide the surgical strategy.Finally,radiological staging allows detection of patients with distant metastasis in the liver or peritoneum who will not benefit from a surgical approach.展开更多
To investigate the prognostic value of the radiological response after transarterial chemoembolization (TACE) and inflammatory markers in patients affected by hepatocellular carcinoma (HCC) awaiting liver transplantat...To investigate the prognostic value of the radiological response after transarterial chemoembolization (TACE) and inflammatory markers in patients affected by hepatocellular carcinoma (HCC) awaiting liver transplantation (LT).METHODSWe retrospectively evaluated the preoperative predictors of HCC recurrence in 70 patients treated with conventional (n = 16) or doxorubicin-eluting bead TACE (n = 54) before LT. The patient and tumour characteristics, including the static and dynamic alpha-fetoprotein, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) measurements, were recorded. Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST) and the European Association for the Study of the Liver (EASL) criteria as complete response (CR), partial response (PR), stable disease or progressive disease. After examination of the explanted livers, histological necrosis was classified as complete (100% of the cumulative tumour area), partial (50%-99%) or minimal (< 50%) and was correlated with the preoperative radiological findings.RESULTSAccording to the pre-TACE radiological evaluation, 22/70 (31.4%) and 12/70 (17.1%) patients were beyond Milan and University of San Francisco (UCSF) criteria, respectively. After TACE procedures, the objective response (CR + PR) rates were 71.4% and 70.0% according to mRECIST and EASL criteria, respectively. The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response (weighted k-value: 0.98 and 0.93, respectively). Complete and partial histological necrosis were achieved in 14/70 (20.0%) and 28/70 (40.0%) patients, respectively. Using histopathology as the reference standard, mRECIST criteria correctly classified necrosis in 72.9% (51/70) of patients and EASL criteria in 68.6% (48/70) of cases. The mRECIST non-response to TACE [Exp(b) = 9.2, p = 0.012], exceeding UCSF criteria before TACE [Exp(b) = 4.7, p = 0.033] and a preoperative PLR > 150 [Exp(b) = 5.9, p = 0.046] were independent predictors of tumour recurrence.CONCLUSIONThe radiological response and inflammatory markers are predictive of tumour recurrence and allow the proper selection of TACE-treated candidates for LT.展开更多
OBJECTIVE: To explore the role and mechanism of a radiation protection cream(Rp) in the treatment of radiation dermatitis, and to accumulate necessary technical information for a new drug report on Rp.METHODS: High-pe...OBJECTIVE: To explore the role and mechanism of a radiation protection cream(Rp) in the treatment of radiation dermatitis, and to accumulate necessary technical information for a new drug report on Rp.METHODS: High-performance liquid chromatography was used to establish the method of measuring the main effective ingredients of sovereign and adjuvant herbs of Rp drugs, and to formulate the draft quality standards of Rp. A total of 48Sprague-Dawley male rats were randomly divided into the Model,Trolamine cream(Tc), Rp and Blank groups according to a random number table method.The skin of each rat's buttocks was irradiated using an electron linear accelerator to establish an acute radiation dermatitis model. The histological changes were observed under light microscopy and electron microscopy during wound healing and the effect of Rp on rat fibroblast Ku70/80 gene expression was detected at the transcriptional level.RESULTS: Pathological examination revealed that Rp protected the cellular and subcellular structures of skin after irradiation, promoting the proliferation and restoration of collagen fibers. Ku70/80 mRNA expression levels in the Rp and Tc groups were higher than that in the model group(P<0.05).Moreover,The majority of grade radiation dermatitis relative to the Model, Rp and Tc groups for reducing grade Ⅲ and Ⅳ dermatitis efficiency were 85.7%and 69.2%(P<0.05), respectively.The efficacy of Rp group in treating radiation dermatitis was better than the Trolamine cream group by16.5%(P<0.05).CONCLUSION: Compared with Tc, Rp had certain advantages in the efficacy and performance to price ratio.Thus, Rp is considered an effective alternative formulation for the prevention and treatment of radiation dermatitis.展开更多
BACKGROUND Wernicke's encephalopathy is a disease caused by thiamine deficiency.The lesions usually involve the periphery of the aqueduct,midbrain,tectum,third ventricle,papillary body,and thalamus.It is very rare...BACKGROUND Wernicke's encephalopathy is a disease caused by thiamine deficiency.The lesions usually involve the periphery of the aqueduct,midbrain,tectum,third ventricle,papillary body,and thalamus.It is very rare to affect the vermis and cerebellar hemispheres.CASE SUMMARY We report a 77-year-old female patient admitted to the emergency department of our hospital for 2 d of unconsciousness.Brain magnetic resonance imaging showed increased diffusion weighted imaging signals in the bilateral thalamus,periventricular regions of the third ventricle,corpora quadrigemina,vermis,and cerebellar hemispheres.Wernicke's encephalopathy was considered.She was given thiamine therapy and became conscious after the treatment.CONCLUSION Wernicke's encephalopathy may have various imaging manifestations.Clinicians should keep in mind that Wernicke’s encephalopathy may occur in patients who experience prolonged periods of malnutrition.展开更多
BACKGROUND The most widely accepted treatment for pediatric supracondylar humeral fracture is closed reduction and percutaneous pinning(CRPP). However, there is debate regarding the technique that is utilized, whether...BACKGROUND The most widely accepted treatment for pediatric supracondylar humeral fracture is closed reduction and percutaneous pinning(CRPP). However, there is debate regarding the technique that is utilized, whether crossed or lateral pinning, and the number of pins used.AIM To compare the functional and radiological outcomes of lateral and cross pinning in the management of humeral supracondylar fracture.METHODS A retrospective analysis was performed on 101 patients who were surgically managed by either one of the CRPP techniques from 2015 to 2019. Several clinical parameters were taken into account, including pre-and post-intervention Baumann angle, as well as scores for pain, range of motion, function, and stability. Statistical analysis was performed to study the outcomes of the utilized techniques.RESULTS Amongst our study sample, which included 63 males and 38 females with a mean age of 5.87 years, about one-third of the patients underwent crossed pinning fixation configuration and the remaining two-thirds were managed by lateral pinning configuration. Similar results were obtained in the two groups with no statistical difference regarding Mayo elbow performance scores(MEPS) and Baumann angle. The mean MEPS in the lateral and crossed pinning groups were 93.68 + 8.59 and 93.62 + 9.05, respectively. The mean Baumann angle was 72.5° + 6.46 in the lateral group and 72.3° + 4.70 in the crossed-pinning group(P = 0.878).CONCLUSION Both lateral pinning and crossed pinning fixation configuration for displaced pediatric supracondylar humeral fractures provide similar functional and radiological outcomes.展开更多
This study investigated the level of natural radioactivity and radiological risks of 40 different ceramic tiles through gamma-ray spectroscopy using a high-purity germanium detector. The calculated activity concentrat...This study investigated the level of natural radioactivity and radiological risks of 40 different ceramic tiles through gamma-ray spectroscopy using a high-purity germanium detector. The calculated activity concentrations were evaluated to determine their potential radiological risks to human health. Furthermore, the activity concentrations were subjected to the RESRAD-BUILD computer code to assess the effect of ventilation rate, dweller position, and room size and direction on the total effective dose(TED). The simulated TED received by a receptor when changing the ventilation rate in a room ranged from0.26 ± 0.01 to 0.61 ± 0.01 mSv/y; however,the percentage variations in the TED due to dweller position and room size are 34, 31,and 35% and 33, 27, and 40% for the x-,y-,and z-directions, respectively. The overall TED received by the dweller based on room size and direction is 0.75 mSv/y. The calculated radiological risk parameters were all below the recommended maximum limit. However, the TED received by the dweller is significantly affected by the directions of the measurement, position,room size,and ventilation. Therefore,estimating the TED from one direction would underestimate the total dose received by the dweller.展开更多
Gastric schwannomas are rare mesenchymal tumors of the gastrointestinal tract.They are usually misdiagnosed as other submucosal tumors preoperatively.Experience of the imaging features of gastric schwannomas is extrem...Gastric schwannomas are rare mesenchymal tumors of the gastrointestinal tract.They are usually misdiagnosed as other submucosal tumors preoperatively.Experience of the imaging features of gastric schwannomas is extremely limited.In this report,we summarize the features of a series of endoscopic ultrasound(EUS) images of gastric schwannomas in an effort to improve the diagnosis and differential diagnosis rate.We retrospectively reviewed the endosonographic features of four patients with gastric schwannomas and their computed tomography imaging results.Gastric schwannomas had heterogeneous hypoechogenicity or isoechogenicity,and a well-demarcated margin.The tumors originated from the fourth layer.Cystic changes and calcification were uncommon.Marginal hypoechoic haloes were observed in two patients.The results described here were different from those of previous studies.In the EUS evaluation,the internal echogenicity of gastric schwannomas was heterogeneous and low,but slightly higher than that of muscularis pro-pria.These features might help us differentiate gastric schwannomas from other submucosal tumors.Further investigation is needed to differentiate these mesenchymal tumors.展开更多
BACKGROUND:Locoregional therapies(LRTs) are treatments to achieve local control of hepatocellular carcinoma(HCC).Correlation between radiologic response to LRT and degree of induced tumor necrosis is not well understo...BACKGROUND:Locoregional therapies(LRTs) are treatments to achieve local control of hepatocellular carcinoma(HCC).Correlation between radiologic response to LRT and degree of induced tumor necrosis is not well understood.The aim of this study was to evaluate different levels of radiologic response after pre-liver transplant(LT) LRT and its correlation with percentage of tumor necrosis on explanted histopathology.METHODS:Institutional Review Board approved LT database was queried for treated HCC in patients undergoing LT.Radiologic response was evaluated to predict tumor necrosis in the explanted liver.Tumor response was evaluated 1 to 3 months after LRT with computed tomography or MRI via Response Evaluation Criteria in Solid Tumors(RECIST),and European Association for the Study of the Liver(EASL) guidelines.LRT was repeated as needed until time of LT.Histological tumor necrosis was graded as complete(100%),partial(50%-99%),or poor(【50%).RESULTS:Between 2002 and 2011,128 patients(97 men and 31 women) received pre-LT LRT including transarterial therapy(93),radiofrequency ablation(20),or combination of both(15).The mean age of the patients was 58±9 years.Their mean follow-up was 35±27 months.The median waitlist time was 55 days.One hundred(78%) patients had HCC within the Milan criteria at the initial radiologic diagnosis.Nineteen(15%) of the patients had complete tumor necrosis on histopathology analysis.Fifty(39%) of the patients exhibited partial necrosis,52(41%) showed poor or no necrosis and 7(5%) showed progressive disease.The overall pre-LT radiologic staging was correlated with explant pathology in 73(57%) of the patients.Underestimated tumor stage was noted in 49(38%) patients,and overestimated tumor stage in 6(5%) patients.The post-LT 3-year overall survival and disease free survival were 82% and 80%,and the rates for complete and partial tumor necrosis were 100% vs 78%(P=0.02) and 100% vs 75%(P=0.03),respectively.CONCLUSIONS:In the current era,interpretation of radiologic response after LRT for HCC does not correlate accurately with histologic tumor necrosis.Total tumor necrosis is the goal of LRT;therefore,evolution in its performance is needed.Similarly,ways to predict therapy induced tumor necrosis via radiological investigation need to be improved.展开更多
AIM:To assess the concordance between diagnosing orbital lesions by clinical examination,orbital imaging,and histological evaluation,in order to help guide future research and clinical practice.METHODS:A retrospective...AIM:To assess the concordance between diagnosing orbital lesions by clinical examination,orbital imaging,and histological evaluation,in order to help guide future research and clinical practice.METHODS:A retrospective analysis was undertaken at a large regional tertiary referral centre of all surgical orbital biopsies performed over a 5-year period,from 1st January 2015 until 31st December 2019.Accuracy and concordance between clinical,radiological and histological diagnoses are reported as percentage sensitivity and positive predictive value.RESULTS:A total of 128 operations involving 111 patients were identified.Overall,sensitivities of 47.7%for clinical and 37.3%for radiological diagnoses were found when compared to the histological gold standard.Vascular lesions that have characteristic clinical and radiological features had the highest sensitivity at 71.4%and 57.1%,respectively.Inflammatory conditions showed the lowest sensitivity in both clinical(30.3%)and radiological(18.2%)diagnoses.The PPV for inflammatory conditions were 47.6%for clinical and 30.0%for radiological diagnoses.CONCLUSION:Accurate diagnoses are difficult to reach by relying on clinical examination and imaging alone.Surgical orbital biopsy with histological diagnosis should remain the gold standard approach for definitively identifying orbital lesions.Although larger scale prospective studies would help further refine concordance and guide future research avenues.展开更多
Background:Early singular nodular hepatocellular carcinoma(HCC)is an ideal surgical indication in clinical practice.However,almost half of the patients have tumor recurrence,and there is no reliable prognostic predict...Background:Early singular nodular hepatocellular carcinoma(HCC)is an ideal surgical indication in clinical practice.However,almost half of the patients have tumor recurrence,and there is no reliable prognostic prediction tool.Besides,it is unclear whether preoperative neoadjuvant therapy is necessary for patients with early singular nodular HCC and which patient needs it.It is critical to identify the patients with high risk of recurrence and to treat these patients preoperatively with neoadjuvant therapy and thus,to improve the outcomes of these patients.The present study aimed to develop two prognostic models to preoperatively predict the recurrence-free survival(RFS)and overall survival(OS)in patients with singular nodular HCC by integrating the clinical data and radiological features.Methods:We retrospective recruited 211 patients with singular nodular HCC from December 2009 to January 2019 at Eastern Hepatobiliary Surgery Hospital(EHBH).They all met the surgical indications and underwent radical resection.We randomly divided the patients into the training cohort(n=132)and the validation cohort(n=79).We established and validated multivariate Cox proportional hazard models by the preoperative clinicopathologic factors and radiological features for association with RFS and OS.By analyzing the receiver operating characteristic(ROC)curve,the discrimination accuracy of the models was compared with that of the traditional predictive models.Results:Our RFS model was based on HBV-DNA score,cirrhosis,tumor diameter and tumor capsule in imaging.RFS nomogram had fine calibration and discrimination capabilities,with a C-index of 0.74(95%CI:0.68-0.80).The OS nomogram,based on cirrhosis,tumor diameter and tumor capsule in imaging,had fine calibration and discrimination capabilities,with a C-index of 0.81(95%CI:0.74-0.87).The area under the receiver operating characteristic curve(AUC)of our model was larger than that of traditional liver cancer staging system,Korea model and Nomograms in Hepatectomy Patients with Hepatitis B VirusRelated Hepatocellular Carcinoma,indicating better discrimination capability.According to the models,we fitted the linear prediction equations.These results were validated in the validation cohort.Conclusions:Compared with previous radiography model,the new-developed predictive model was concise and applicable to predict the postoperative survival of patients with singular nodular HCC.Our models may preoperatively identify patients with high risk of recurrence.These patients may benefit from neoadjuvant therapy which may improve the patients’outcomes.展开更多
BACKGROUND High tibial osteotomy(HTO)is a well-known procedure for the correction of knee varus.The purpose of this study was to compare the radiological results and accuracy of deformity correction performed using tw...BACKGROUND High tibial osteotomy(HTO)is a well-known procedure for the correction of knee varus.The purpose of this study was to compare the radiological results and accuracy of deformity correction performed using two different techniques:acute opening wedge correction using a plate and gradual correction with a monolateral external fixator.AIM To compare of the radiological results of two different techniques:acute opening wedge correction(a plate and screw)and gradual correction(external fixator).METHODS A total of 43 patients with plates and 36 patients with external fixators were included.All patients had moderate uniplanar varus deformities.We measured radiographic parameters,including the mechanical axis deviation(MAD),medial proximal tibial angle(MPTA),Caton-Deschamps Index(CDI),posterior proximal tibial angle,and joint line obliquity angle(JLOA).The accuracy of MAD correction was calculated based on a correction goal of neutral or overcorrection for medial compartment arthritis.RESULTS Demographics including age,body mass index,sex,and preoperative deformities were similar between the groups.The MAD significantly improved from 23.6 mm medial to the midline(SD=8.2 mm)to 6.9 mm lateral to the midline(SD=5.4 mm)(P<0.001).The accuracy of MAD correction did not differ between the groups and was 96.1%(SD=8.1%)in the plate group and 98.2%(SD=5.2%)in the external fixator group(P=0.18).The MPTA significantly improved from 83.9°(SD=2.9°)to 90.9°(SD=3.3°)(P<0.001),and the change was similar between the groups.Differences were noted in patella height,with a CDI change of-19.2%(SD=13.7%)and 3.1%(SD=8.0%)for the plate and external fixator groups,respectively(P<0.001).The change in JLOA was 1.6 degrees(SD=1.1 degrees)and 0.9 degrees(SD=0.9 degrees)for the plate and external fixator groups,respectively(P=0.04).CONCLUSION Reliable correction of moderate varus alignment was achieved with both the acute opening wedge technique with a plate and the gradual monolateral external fixator technique.The patellar height decreased with the open wedge plate technique.Joint line obliquity decreased to a greater degree with the open wedge plate technique,perhaps as a result of medial collateral ligament release.The appropriate technique should be selected based on surgeon and patient preferences;however,external fixation may be a better choice when the preservation of patellar height is deemed important.展开更多
Patellofemoral instability(PI)is the disruption of the patella’s relationship with the trochlear groove as a result of abnormal movement of the patella.To identify the presence of PI,conventional radiographs(anteropo...Patellofemoral instability(PI)is the disruption of the patella’s relationship with the trochlear groove as a result of abnormal movement of the patella.To identify the presence of PI,conventional radiographs(anteroposterior,lateral,and axial or skyline views),magnetic resonance imaging,and computed tomography are used.In this study,we examined four main instability factors:Trochlear dysplasia,patella alta,tibial tuberosity–trochlear groove distance,and patellar tilt.We also briefly review some of the other assessment methods used in the quantitative and qualitative assessment of the patellofemoral joint,such as patellar size and shape,lateral trochlear inclination,trochlear depth,trochlear angle,and sulcus angle,in cases of PI.In addition,we reviewed the evaluation of coronal alignment,femoral anteversion,and tibial torsion.Possible causes of error that can be made when evaluating these factors are examined.PI is a multi-factorial problem.Many problems affecting bone structure and muscles morphologically and functionally can cause this condition.It is necessary to understand normal anatomy and biomechanics to make more accurate radiological measurements and to identify causes.Knowing the possible causes of measurement errors that may occur during radiological measurements and avoiding these pitfalls can provide a more reliable road map for treatment.This determines whether the disease will be treated medically and with rehabilitation or surgery without causing further complications.展开更多
This work was carried out to measure the radioactivity level in the coastal areas of Nigeria by gamma counting of river sediment samples and assess the radiological impact associated with the use of the river sediment...This work was carried out to measure the radioactivity level in the coastal areas of Nigeria by gamma counting of river sediment samples and assess the radiological impact associated with the use of the river sediments as building material. The method of gamma spectrometry with a 7.6 cm by 7.6 cm NaI(Tl) detector was employed in determining 40K, 238U and 232Th levels in 95 and 38 sediment samples respectively collected from representative sites in the oil producing and non oil producing coastal areas of Nigeria. Results of the samples assayed showed that the radioactivity concentrations of 40K, 226Ra and 228Ra in the sediment samples of oil producing areas range from 95.4 to 160.0;7.6 to 31.0 and 9.5 to 41.6 Bq kg–1, respectively. The respective means were calculated as 122.39 ± 47.49;18.93 ± 12.53 and 29.31 ± 18.67 Bq kg–1. In the sediment samples from the non oil producing areas, the respective mean values are 88.48 ± 8.22, 14.87 ± 3.51 and 16.37 ± 3.87 Bq kg–1. Statistical analysis of the results showed that there is no significant difference between the radionuclide concentration of the sediment samples from different rivers in the oil producing and non oil producing coastal areas, except for 40K. The values of the natural radionuclide concentrations however translate to the determina-tion of the radiological impact assessment values. The values of the radiological assessment indices obtained were ob-served to be lower than limits internationally reported and recommended for building materials. It could therefore be reported that the operations of the oil companies in the coastline, involving use of radioactive materials have not contributed adversely to the radioactivity level of the river sediments and that the use of river sediments as building mate-rial in the coastal areas of Nigeria poses no radiological risk.展开更多
文摘There are various histological characteristics which have been proposed to predict the survival rate in colon cancer.However,there is no definitive model to accurately predict the survival.Therefore,it is important to find out one model for the prediction of survival in colon cancer which may also include the preoperative,and operative factors in addition to histopathology.
文摘Magnetic resonance enterography(MRE)is a non-invasive,radiation-free imaging modality that facilitates the assessment of transmural Crohn’s disease activity.It offers advantages over ileo-colonoscopy,which is limited to mucosal-level evaluation,cannot routinely assess small bowel segments proximal to the terminal ileum,and is unable to detect extra-luminal complications.Despite these ad-vantages,the lack of standardised criteria for defining and appraising radiologic disease activity on MRE has contributed to variability in interpretation and clinical application.In response,multiple MRE-based scoring systems have been developed to quantify radiological Crohn’s disease activity in both luminal and post-operative settings.Radiological disease activity scores specific to luminal Crohn’s disease include the magnetic resonance index of activity(MaRIA),simplified MaRIA,Nancy score,London score,Crohn’s disease magnetic reso-nance imaging(MRI)index,Clermont score,paediatric inflammatory Crohn’s MRE index,MRE global score,MRE index,and modified Clermont score.The MR score and the MRI in Crohn’s disease to predict postoperative recurrence index have been specifically developed to evaluate post-operative disease recurrence in Crohn’s disease.Nevertheless,heterogeneity in scoring parameters,variability in computational complexity,and a lack of consensus regarding optimal score selection,have impeded widespread clinical adoption of radiological disease activity scores.This narrative review aims to summarise the key imaging features of luminal Crohn’s disease,explore their integration into existing MRE scoring indices,and critically compare the structure,strengths,and clinical applicability of each.Furthermore,MRI scores specific to post-operative Crohn’s disease evaluation,and the assessment of cumulative bowel wall damage using the Lemann index will also be discussed.
文摘Colorectal cancer(CRC)remains one of the leading causes of cancer-related mortality worldwide.Despite advances in early detection and treatment,approximately half of patients with CRC develop liver metastases(LM),complicating therapeutic strategies and reducing survival rates.Radiological imaging is critical in managing colorectal LM by guiding detection,staging,treatment planning,and response evaluation.This letter to the editor provides a comprehensive overview of both traditional and emerging imaging modalities,including computed tomography,magnetic resonance imaging,and positron emission tomography,and their specific roles in clinical decision-making.It further explores advanced techniques such as radiomics,artificial intelligence,and radiogenomics,which integrate quantitative imaging features with genetic and clinical data to enhance prognostication and tailor personalized treatment approaches.Specific examples of how these innovations are applied in treatment response assessment and presurgical planning are highlighted.The discussion also emphasizes the need for large-scale prospective clinical trials and standardized protocols to validate current predictive models and fully integrate these advanced methodologies into clinical practice.
文摘Gamma-ray spectroscopy based on a 100% efficiency hyper-pure germanium detector was used to evaluate the activity concentrations of <sup>226</sup>Ra, <sup>232</sup>Th, and <sup>40</sup>K natural radionuclides in sedimentary, conglomerate, igneous and sedi-ments rock samples collected from four different locations in Eastern desert in Egypt. The obtained activity concentrations are used to evaluate the radi-ological hazards indices, absorbed dose rate, annual effective dose equivalent in air, radium equivalent, external and internal hazard index, radiation level index, annual gonadal dose equivalent, excess lifetime cancer risk and expo-sure rate. The results show that 1) the absorbed dose rate depends on the rock type, 2) the annual effective dose equivalent in air in 71% of sample below 20 mSvy<sup>-1</sup> (permissible limit for workers), 3) the conglomerate rocks show low radioactivity level, 4) sedimentary rocks are rich in radium while igneous rocks are rich in thorium and the sediments rocks are rich in both radium and thorium.
文摘Introduction: Radiology and medical imaging examinations bring together the means of acquiring and restoring images of the human body from different physical phenomena such as the absorption of X-rays, nuclear magnetic resonance, reflection of ultrasound waves or radioactivity, with which we sometimes associate optical imaging techniques such as endoscopy. The objective of our study was to study the profile of radiological examinations in the radiology and medical imaging department of the “KALALE” medical clinic. Methodology: This was a descriptive, prospective study that took place over a period of six (6) months in the radiology and medical imaging department of the “KALALE” medical clinic and the centers of health of communes III and IV of Bamako in Mali. Data collection was carried out on a survey form. The parameters studied were sociodemographic data, clinical data, radiological data. Results: We recorded 6030 radiology examinations of which 19% of the examination frequency cases came from the “KALALE” medical clinic and 81% of the cases were referrals from the reference health centers of communes III and IV. There were 1500 X-rays or 24.9% of cases including 54% cases of bone X-rays;5% of cases of skull and face X-rays;5% of cases of Intravenous Urography (IVU);4% of cases of Hysterosalpingography (HSG);3% of cases of Retrograde Ureterocystography (UCR) and 1% of cases of X-ray of the Abdomen without preparation (ASP). We found 4530 ultrasounds or 75.1% of cases. Conclusion: Medical imaging has become essential in the study of the human body and now constitutes an essential tool for the detection and treatment of most pathologies, from simple fractures to the most serious tumors.
文摘Hepatic artery thrombosis(HAT)is a devastating vascular complication following liver transplantation,requiring prompt diagnosis and rapid revascularization treatment to prevent graft loss.At present,imaging modalities such as ultrasound,computed tomography,and magnetic resonance play crucial roles in diagnosing HAT.Although imaging techniques have improved sensitivity and specificity for HAT diagnosis,they have limitations that hinder the timely diagnosis of this complication.In this sense,the emergence of artificial intelligence(AI)presents a transformative opportunity to address these diagnostic limitations.The development of machine learning algorithms and deep neural networks has demonstrated the potential to enhance the precision diagnosis of liver transplant complications,enabling quicker and more accurate detection of HAT.This article examines the current landscape of imaging diagnostic techniques for HAT and explores the emerging role of AI in addressing future challenges in the diagnosis of HAT after liver transplant.
文摘Hilar cholangiocarcinoma is a rare malignant tumor arising from the epithelium of the bile ducts.Surgery is still the only chance of potentially curative treatment in patients with perihilar cholangiocarcinoma.However,radical resection requires aggressive surgical strategies that should be tailored optimally according to the location,size and vascular invasion of the tumors.Accurate diagnosis and staging of these tumors is therefore critical for optimal treatment planning and for determining a prognosis.Multidetector computed tomography(MDCT),magnetic resonance imaging(MRI) and MR cholangiography are useful tools,both to diagnose and stage hilar cholangiocarcinoma.Modern imaging techniques allow accurate detection of the level of obstruction and the longitudinal and radial spread of the tumor.In addition,high-resolution MDCT and MR provide specific radiographic features to determine vascular involvement of anatomic structures,such as the hepatic artery or the portal vein,which are critical to decide the surgical strategy.Finally,radiological staging allows detection of patients with distant metastasis in the liver or peritoneum who will not benefit from a surgical approach.
文摘To investigate the prognostic value of the radiological response after transarterial chemoembolization (TACE) and inflammatory markers in patients affected by hepatocellular carcinoma (HCC) awaiting liver transplantation (LT).METHODSWe retrospectively evaluated the preoperative predictors of HCC recurrence in 70 patients treated with conventional (n = 16) or doxorubicin-eluting bead TACE (n = 54) before LT. The patient and tumour characteristics, including the static and dynamic alpha-fetoprotein, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) measurements, were recorded. Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST) and the European Association for the Study of the Liver (EASL) criteria as complete response (CR), partial response (PR), stable disease or progressive disease. After examination of the explanted livers, histological necrosis was classified as complete (100% of the cumulative tumour area), partial (50%-99%) or minimal (< 50%) and was correlated with the preoperative radiological findings.RESULTSAccording to the pre-TACE radiological evaluation, 22/70 (31.4%) and 12/70 (17.1%) patients were beyond Milan and University of San Francisco (UCSF) criteria, respectively. After TACE procedures, the objective response (CR + PR) rates were 71.4% and 70.0% according to mRECIST and EASL criteria, respectively. The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response (weighted k-value: 0.98 and 0.93, respectively). Complete and partial histological necrosis were achieved in 14/70 (20.0%) and 28/70 (40.0%) patients, respectively. Using histopathology as the reference standard, mRECIST criteria correctly classified necrosis in 72.9% (51/70) of patients and EASL criteria in 68.6% (48/70) of cases. The mRECIST non-response to TACE [Exp(b) = 9.2, p = 0.012], exceeding UCSF criteria before TACE [Exp(b) = 4.7, p = 0.033] and a preoperative PLR > 150 [Exp(b) = 5.9, p = 0.046] were independent predictors of tumour recurrence.CONCLUSIONThe radiological response and inflammatory markers are predictive of tumour recurrence and allow the proper selection of TACE-treated candidates for LT.
基金Supported by the Science and Technology Development Project of Jinan(No.201121057)
文摘OBJECTIVE: To explore the role and mechanism of a radiation protection cream(Rp) in the treatment of radiation dermatitis, and to accumulate necessary technical information for a new drug report on Rp.METHODS: High-performance liquid chromatography was used to establish the method of measuring the main effective ingredients of sovereign and adjuvant herbs of Rp drugs, and to formulate the draft quality standards of Rp. A total of 48Sprague-Dawley male rats were randomly divided into the Model,Trolamine cream(Tc), Rp and Blank groups according to a random number table method.The skin of each rat's buttocks was irradiated using an electron linear accelerator to establish an acute radiation dermatitis model. The histological changes were observed under light microscopy and electron microscopy during wound healing and the effect of Rp on rat fibroblast Ku70/80 gene expression was detected at the transcriptional level.RESULTS: Pathological examination revealed that Rp protected the cellular and subcellular structures of skin after irradiation, promoting the proliferation and restoration of collagen fibers. Ku70/80 mRNA expression levels in the Rp and Tc groups were higher than that in the model group(P<0.05).Moreover,The majority of grade radiation dermatitis relative to the Model, Rp and Tc groups for reducing grade Ⅲ and Ⅳ dermatitis efficiency were 85.7%and 69.2%(P<0.05), respectively.The efficacy of Rp group in treating radiation dermatitis was better than the Trolamine cream group by16.5%(P<0.05).CONCLUSION: Compared with Tc, Rp had certain advantages in the efficacy and performance to price ratio.Thus, Rp is considered an effective alternative formulation for the prevention and treatment of radiation dermatitis.
基金the Hangzhou Science and Technology Bureau,No.20191203B84.
文摘BACKGROUND Wernicke's encephalopathy is a disease caused by thiamine deficiency.The lesions usually involve the periphery of the aqueduct,midbrain,tectum,third ventricle,papillary body,and thalamus.It is very rare to affect the vermis and cerebellar hemispheres.CASE SUMMARY We report a 77-year-old female patient admitted to the emergency department of our hospital for 2 d of unconsciousness.Brain magnetic resonance imaging showed increased diffusion weighted imaging signals in the bilateral thalamus,periventricular regions of the third ventricle,corpora quadrigemina,vermis,and cerebellar hemispheres.Wernicke's encephalopathy was considered.She was given thiamine therapy and became conscious after the treatment.CONCLUSION Wernicke's encephalopathy may have various imaging manifestations.Clinicians should keep in mind that Wernicke’s encephalopathy may occur in patients who experience prolonged periods of malnutrition.
文摘BACKGROUND The most widely accepted treatment for pediatric supracondylar humeral fracture is closed reduction and percutaneous pinning(CRPP). However, there is debate regarding the technique that is utilized, whether crossed or lateral pinning, and the number of pins used.AIM To compare the functional and radiological outcomes of lateral and cross pinning in the management of humeral supracondylar fracture.METHODS A retrospective analysis was performed on 101 patients who were surgically managed by either one of the CRPP techniques from 2015 to 2019. Several clinical parameters were taken into account, including pre-and post-intervention Baumann angle, as well as scores for pain, range of motion, function, and stability. Statistical analysis was performed to study the outcomes of the utilized techniques.RESULTS Amongst our study sample, which included 63 males and 38 females with a mean age of 5.87 years, about one-third of the patients underwent crossed pinning fixation configuration and the remaining two-thirds were managed by lateral pinning configuration. Similar results were obtained in the two groups with no statistical difference regarding Mayo elbow performance scores(MEPS) and Baumann angle. The mean MEPS in the lateral and crossed pinning groups were 93.68 + 8.59 and 93.62 + 9.05, respectively. The mean Baumann angle was 72.5° + 6.46 in the lateral group and 72.3° + 4.70 in the crossed-pinning group(P = 0.878).CONCLUSION Both lateral pinning and crossed pinning fixation configuration for displaced pediatric supracondylar humeral fractures provide similar functional and radiological outcomes.
基金supported by the Universiti Kebangsaan Malaysia(UKM)under Grant Number GGPM-2017-084
文摘This study investigated the level of natural radioactivity and radiological risks of 40 different ceramic tiles through gamma-ray spectroscopy using a high-purity germanium detector. The calculated activity concentrations were evaluated to determine their potential radiological risks to human health. Furthermore, the activity concentrations were subjected to the RESRAD-BUILD computer code to assess the effect of ventilation rate, dweller position, and room size and direction on the total effective dose(TED). The simulated TED received by a receptor when changing the ventilation rate in a room ranged from0.26 ± 0.01 to 0.61 ± 0.01 mSv/y; however,the percentage variations in the TED due to dweller position and room size are 34, 31,and 35% and 33, 27, and 40% for the x-,y-,and z-directions, respectively. The overall TED received by the dweller based on room size and direction is 0.75 mSv/y. The calculated radiological risk parameters were all below the recommended maximum limit. However, the TED received by the dweller is significantly affected by the directions of the measurement, position,room size,and ventilation. Therefore,estimating the TED from one direction would underestimate the total dose received by the dweller.
文摘Gastric schwannomas are rare mesenchymal tumors of the gastrointestinal tract.They are usually misdiagnosed as other submucosal tumors preoperatively.Experience of the imaging features of gastric schwannomas is extremely limited.In this report,we summarize the features of a series of endoscopic ultrasound(EUS) images of gastric schwannomas in an effort to improve the diagnosis and differential diagnosis rate.We retrospectively reviewed the endosonographic features of four patients with gastric schwannomas and their computed tomography imaging results.Gastric schwannomas had heterogeneous hypoechogenicity or isoechogenicity,and a well-demarcated margin.The tumors originated from the fourth layer.Cystic changes and calcification were uncommon.Marginal hypoechoic haloes were observed in two patients.The results described here were different from those of previous studies.In the EUS evaluation,the internal echogenicity of gastric schwannomas was heterogeneous and low,but slightly higher than that of muscularis pro-pria.These features might help us differentiate gastric schwannomas from other submucosal tumors.Further investigation is needed to differentiate these mesenchymal tumors.
文摘BACKGROUND:Locoregional therapies(LRTs) are treatments to achieve local control of hepatocellular carcinoma(HCC).Correlation between radiologic response to LRT and degree of induced tumor necrosis is not well understood.The aim of this study was to evaluate different levels of radiologic response after pre-liver transplant(LT) LRT and its correlation with percentage of tumor necrosis on explanted histopathology.METHODS:Institutional Review Board approved LT database was queried for treated HCC in patients undergoing LT.Radiologic response was evaluated to predict tumor necrosis in the explanted liver.Tumor response was evaluated 1 to 3 months after LRT with computed tomography or MRI via Response Evaluation Criteria in Solid Tumors(RECIST),and European Association for the Study of the Liver(EASL) guidelines.LRT was repeated as needed until time of LT.Histological tumor necrosis was graded as complete(100%),partial(50%-99%),or poor(【50%).RESULTS:Between 2002 and 2011,128 patients(97 men and 31 women) received pre-LT LRT including transarterial therapy(93),radiofrequency ablation(20),or combination of both(15).The mean age of the patients was 58±9 years.Their mean follow-up was 35±27 months.The median waitlist time was 55 days.One hundred(78%) patients had HCC within the Milan criteria at the initial radiologic diagnosis.Nineteen(15%) of the patients had complete tumor necrosis on histopathology analysis.Fifty(39%) of the patients exhibited partial necrosis,52(41%) showed poor or no necrosis and 7(5%) showed progressive disease.The overall pre-LT radiologic staging was correlated with explant pathology in 73(57%) of the patients.Underestimated tumor stage was noted in 49(38%) patients,and overestimated tumor stage in 6(5%) patients.The post-LT 3-year overall survival and disease free survival were 82% and 80%,and the rates for complete and partial tumor necrosis were 100% vs 78%(P=0.02) and 100% vs 75%(P=0.03),respectively.CONCLUSIONS:In the current era,interpretation of radiologic response after LRT for HCC does not correlate accurately with histologic tumor necrosis.Total tumor necrosis is the goal of LRT;therefore,evolution in its performance is needed.Similarly,ways to predict therapy induced tumor necrosis via radiological investigation need to be improved.
文摘AIM:To assess the concordance between diagnosing orbital lesions by clinical examination,orbital imaging,and histological evaluation,in order to help guide future research and clinical practice.METHODS:A retrospective analysis was undertaken at a large regional tertiary referral centre of all surgical orbital biopsies performed over a 5-year period,from 1st January 2015 until 31st December 2019.Accuracy and concordance between clinical,radiological and histological diagnoses are reported as percentage sensitivity and positive predictive value.RESULTS:A total of 128 operations involving 111 patients were identified.Overall,sensitivities of 47.7%for clinical and 37.3%for radiological diagnoses were found when compared to the histological gold standard.Vascular lesions that have characteristic clinical and radiological features had the highest sensitivity at 71.4%and 57.1%,respectively.Inflammatory conditions showed the lowest sensitivity in both clinical(30.3%)and radiological(18.2%)diagnoses.The PPV for inflammatory conditions were 47.6%for clinical and 30.0%for radiological diagnoses.CONCLUSION:Accurate diagnoses are difficult to reach by relying on clinical examination and imaging alone.Surgical orbital biopsy with histological diagnosis should remain the gold standard approach for definitively identifying orbital lesions.Although larger scale prospective studies would help further refine concordance and guide future research avenues.
基金supported by grants from the Shanghai Rising-Star Program(19QA1408700)the National Natural Science Founda-tion of China(81972575 and 81521091)Clinical Research Plan of SHDC(SHDC2020CR5007)。
文摘Background:Early singular nodular hepatocellular carcinoma(HCC)is an ideal surgical indication in clinical practice.However,almost half of the patients have tumor recurrence,and there is no reliable prognostic prediction tool.Besides,it is unclear whether preoperative neoadjuvant therapy is necessary for patients with early singular nodular HCC and which patient needs it.It is critical to identify the patients with high risk of recurrence and to treat these patients preoperatively with neoadjuvant therapy and thus,to improve the outcomes of these patients.The present study aimed to develop two prognostic models to preoperatively predict the recurrence-free survival(RFS)and overall survival(OS)in patients with singular nodular HCC by integrating the clinical data and radiological features.Methods:We retrospective recruited 211 patients with singular nodular HCC from December 2009 to January 2019 at Eastern Hepatobiliary Surgery Hospital(EHBH).They all met the surgical indications and underwent radical resection.We randomly divided the patients into the training cohort(n=132)and the validation cohort(n=79).We established and validated multivariate Cox proportional hazard models by the preoperative clinicopathologic factors and radiological features for association with RFS and OS.By analyzing the receiver operating characteristic(ROC)curve,the discrimination accuracy of the models was compared with that of the traditional predictive models.Results:Our RFS model was based on HBV-DNA score,cirrhosis,tumor diameter and tumor capsule in imaging.RFS nomogram had fine calibration and discrimination capabilities,with a C-index of 0.74(95%CI:0.68-0.80).The OS nomogram,based on cirrhosis,tumor diameter and tumor capsule in imaging,had fine calibration and discrimination capabilities,with a C-index of 0.81(95%CI:0.74-0.87).The area under the receiver operating characteristic curve(AUC)of our model was larger than that of traditional liver cancer staging system,Korea model and Nomograms in Hepatectomy Patients with Hepatitis B VirusRelated Hepatocellular Carcinoma,indicating better discrimination capability.According to the models,we fitted the linear prediction equations.These results were validated in the validation cohort.Conclusions:Compared with previous radiography model,the new-developed predictive model was concise and applicable to predict the postoperative survival of patients with singular nodular HCC.Our models may preoperatively identify patients with high risk of recurrence.These patients may benefit from neoadjuvant therapy which may improve the patients’outcomes.
文摘BACKGROUND High tibial osteotomy(HTO)is a well-known procedure for the correction of knee varus.The purpose of this study was to compare the radiological results and accuracy of deformity correction performed using two different techniques:acute opening wedge correction using a plate and gradual correction with a monolateral external fixator.AIM To compare of the radiological results of two different techniques:acute opening wedge correction(a plate and screw)and gradual correction(external fixator).METHODS A total of 43 patients with plates and 36 patients with external fixators were included.All patients had moderate uniplanar varus deformities.We measured radiographic parameters,including the mechanical axis deviation(MAD),medial proximal tibial angle(MPTA),Caton-Deschamps Index(CDI),posterior proximal tibial angle,and joint line obliquity angle(JLOA).The accuracy of MAD correction was calculated based on a correction goal of neutral or overcorrection for medial compartment arthritis.RESULTS Demographics including age,body mass index,sex,and preoperative deformities were similar between the groups.The MAD significantly improved from 23.6 mm medial to the midline(SD=8.2 mm)to 6.9 mm lateral to the midline(SD=5.4 mm)(P<0.001).The accuracy of MAD correction did not differ between the groups and was 96.1%(SD=8.1%)in the plate group and 98.2%(SD=5.2%)in the external fixator group(P=0.18).The MPTA significantly improved from 83.9°(SD=2.9°)to 90.9°(SD=3.3°)(P<0.001),and the change was similar between the groups.Differences were noted in patella height,with a CDI change of-19.2%(SD=13.7%)and 3.1%(SD=8.0%)for the plate and external fixator groups,respectively(P<0.001).The change in JLOA was 1.6 degrees(SD=1.1 degrees)and 0.9 degrees(SD=0.9 degrees)for the plate and external fixator groups,respectively(P=0.04).CONCLUSION Reliable correction of moderate varus alignment was achieved with both the acute opening wedge technique with a plate and the gradual monolateral external fixator technique.The patellar height decreased with the open wedge plate technique.Joint line obliquity decreased to a greater degree with the open wedge plate technique,perhaps as a result of medial collateral ligament release.The appropriate technique should be selected based on surgeon and patient preferences;however,external fixation may be a better choice when the preservation of patellar height is deemed important.
文摘Patellofemoral instability(PI)is the disruption of the patella’s relationship with the trochlear groove as a result of abnormal movement of the patella.To identify the presence of PI,conventional radiographs(anteroposterior,lateral,and axial or skyline views),magnetic resonance imaging,and computed tomography are used.In this study,we examined four main instability factors:Trochlear dysplasia,patella alta,tibial tuberosity–trochlear groove distance,and patellar tilt.We also briefly review some of the other assessment methods used in the quantitative and qualitative assessment of the patellofemoral joint,such as patellar size and shape,lateral trochlear inclination,trochlear depth,trochlear angle,and sulcus angle,in cases of PI.In addition,we reviewed the evaluation of coronal alignment,femoral anteversion,and tibial torsion.Possible causes of error that can be made when evaluating these factors are examined.PI is a multi-factorial problem.Many problems affecting bone structure and muscles morphologically and functionally can cause this condition.It is necessary to understand normal anatomy and biomechanics to make more accurate radiological measurements and to identify causes.Knowing the possible causes of measurement errors that may occur during radiological measurements and avoiding these pitfalls can provide a more reliable road map for treatment.This determines whether the disease will be treated medically and with rehabilitation or surgery without causing further complications.
文摘This work was carried out to measure the radioactivity level in the coastal areas of Nigeria by gamma counting of river sediment samples and assess the radiological impact associated with the use of the river sediments as building material. The method of gamma spectrometry with a 7.6 cm by 7.6 cm NaI(Tl) detector was employed in determining 40K, 238U and 232Th levels in 95 and 38 sediment samples respectively collected from representative sites in the oil producing and non oil producing coastal areas of Nigeria. Results of the samples assayed showed that the radioactivity concentrations of 40K, 226Ra and 228Ra in the sediment samples of oil producing areas range from 95.4 to 160.0;7.6 to 31.0 and 9.5 to 41.6 Bq kg–1, respectively. The respective means were calculated as 122.39 ± 47.49;18.93 ± 12.53 and 29.31 ± 18.67 Bq kg–1. In the sediment samples from the non oil producing areas, the respective mean values are 88.48 ± 8.22, 14.87 ± 3.51 and 16.37 ± 3.87 Bq kg–1. Statistical analysis of the results showed that there is no significant difference between the radionuclide concentration of the sediment samples from different rivers in the oil producing and non oil producing coastal areas, except for 40K. The values of the natural radionuclide concentrations however translate to the determina-tion of the radiological impact assessment values. The values of the radiological assessment indices obtained were ob-served to be lower than limits internationally reported and recommended for building materials. It could therefore be reported that the operations of the oil companies in the coastline, involving use of radioactive materials have not contributed adversely to the radioactivity level of the river sediments and that the use of river sediments as building mate-rial in the coastal areas of Nigeria poses no radiological risk.
