Search results for: chest radiography
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 300

Search results for: chest radiography

240 Assessment of Breeding Soundness by Comparative Radiography and Ultrasonography of Rabbit Testes

Authors: Adenike O. Olatunji-Akioye, Emmanual B Farayola

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In order to improve the animal protein recommended daily intake of Nigerians, there is an upsurge in breeding of hitherto shunned food animals one of which is the rabbit. Radiography and ultrasonography are tools for diagnosing disease and evaluating the anatomical architecture of parts of the body non-invasively. As the rabbit is becoming a more important food animal, to achieve improved breeding of these animals, the best of the species form a breeding stock and will usually depend on breeding soundness which may be evaluated by assessment of the male reproductive organs by these tools. Four male intact rabbits weighing between 1.2 to 1.5 kg were acquired and acclimatized for 2 weeks. Dorsoventral views of the testes were acquired using a digital radiographic machine and a 5 MHz portable ultrasound scanner was used to acquire images of the testes in longitudinal, sagittal and transverse planes. Radiographic images acquired revealed soft tissue images of the testes in all rabbits. The testes lie in individual scrotal sacs sides on both sides of the midline at the level of the caudal vertebrae and thus are superimposed by caudal vertebrae and the caudal limits of the pelvic girdle. The ultrasonographic images revealed mostly homogenously hypoechogenic testes and a hyperechogenic mediastinum testis. The dorsal and ventral poles of the testes were heterogeneously hypoechogenic and correspond to the epididymis and spermatic cord. The rabbit is unique in the ability to retract the testes particularly when stressed and so careful and stressless handling during the procedures is of paramount importance. The imaging of rabbit testes can be safely done using both imaging methods but ultrasonography is a better method of assessment and evaluation of soundness for breeding.

Keywords: breeding soundness, rabbit, radiography, ultrasonography

Procedia PDF Downloads 107
239 Multi-Modality Imaging of Aggressive Hoof Wall Neoplasia in Two Horses

Authors: Hannah Nagel, Hayley Lang, Albert Sole Guitart, Natasha Lean, Rachel Allavena, Cleide Sprohnie-Barrera, Alex Young

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Aggressive neoplasia of the hoof is a rare occurrence in horses and has been only sporadically described in the literature. In the few cases reported intra-hoof wall, aggressive neoplasia has been documented radiographically and has been described with variable imaging characteristics. These include a well-defined osteolytic area, a smoothly outlined semi-circular defect, an extensive draining tract beneath the hoof wall, as well as an additional large area of osteolysis or an extensive central lytic region. A 20-year-old Quarterhorse gelding and a 10-year-old Thoroughbred gelding were both presented for chronic reoccurring lameness in the left forelimb and left hindlimb, respectively. Both of the cases displayed radiographic lesions that have been previously described but also displayed osteoproliferative expansile regions of additional bone formation. Changes associated with hoof neoplasia are often non-specific due to the nature and capacity of bone to react to pathological insult, which is either to proliferate or be absorbed. Both cases depict and describe imaging findings seen on radiography, contrast radiography, computed tomography, and magnetic resonance imaging before reaching a histological diagnosis of malignant melanoma and squamous cell carcinoma. Although aggressive hoof wall neoplasia is rare, there are some imaging features which may raise our index of suspicion for an aggressive hoof wall lesion. This case report documents two horses with similar imaging findings who underwent multiple assessments, surgical interventions, and imaging modalities with a final diagnosis of malignant neoplasia.

Keywords: horse, hoof, imaging, radiography, neoplasia

Procedia PDF Downloads 111
238 C-Spine Imaging in a Non-trauma Centre: Compliance with NEXUS Criteria Audit

Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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237 Objective Evaluation on Medical Image Compression Using Wavelet Transformation

Authors: Amhimmid Mohammed Saffour, Mustafa Mohamed Abdullah

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The use of computers for handling image data in the healthcare is growing. However, the amount of data produced by modern image generating techniques is vast. This data might be a problem from a storage point of view or when the data is sent over a network. This paper using wavelet transform technique for medical images compression. MATLAB program, are designed to evaluate medical images storage and transmission time problem at Sebha Medical Center Libya. In this paper, three different Computed Tomography images which are abdomen, brain and chest have been selected and compressed using wavelet transform. Objective evaluation has been performed to measure the quality of the compressed images. For this evaluation, the results show that the Peak Signal to Noise Ratio (PSNR) which indicates the quality of the compressed image is ranging from (25.89db to 34.35db for abdomen images, 23.26db to 33.3db for brain images and 25.5db to 36.11db for chest images. These values shows that the compression ratio is nearly to 30:1 is acceptable.

Keywords: medical image, Matlab, image compression, wavelet's, objective evaluation

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236 COVID-19 Analysis with Deep Learning Model Using Chest X-Rays Images

Authors: Uma Maheshwari V., Rajanikanth Aluvalu, Kumar Gautam

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The COVID-19 disease is a highly contagious viral infection with major worldwide health implications. The global economy suffers as a result of COVID. The spread of this pandemic disease can be slowed if positive patients are found early. COVID-19 disease prediction is beneficial for identifying patients' health problems that are at risk for COVID. Deep learning and machine learning algorithms for COVID prediction using X-rays have the potential to be extremely useful in solving the scarcity of doctors and clinicians in remote places. In this paper, a convolutional neural network (CNN) with deep layers is presented for recognizing COVID-19 patients using real-world datasets. We gathered around 6000 X-ray scan images from various sources and split them into two categories: normal and COVID-impacted. Our model examines chest X-ray images to recognize such patients. Because X-rays are commonly available and affordable, our findings show that X-ray analysis is effective in COVID diagnosis. The predictions performed well, with an average accuracy of 99% on training photographs and 88% on X-ray test images.

Keywords: deep CNN, COVID–19 analysis, feature extraction, feature map, accuracy

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235 Deep Learning in Chest Computed Tomography to Differentiate COVID-19 from Influenza

Authors: Hongmei Wang, Ziyun Xiang, Ying liu, Li Yu, Dongsheng Yue

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Intro: The COVID-19 (Corona Virus Disease 2019) has greatly changed the global economic, political and financial ecology. The mutation of the coronavirus in the UK in December 2020 has brought new panic to the world. Deep learning was performed on Chest Computed tomography (CT) of COVID-19 and Influenza and describes their characteristics. The predominant features of COVID-19 pneumonia was ground-glass opacification, followed by consolidation. Lesion density: most lesions appear as ground-glass shadows, and some lesions coexist with solid lesions. Lesion distribution: the focus is mainly on the dorsal side of the periphery of the lung, with the lower lobe of the lungs as the focus, and it is often close to the pleura. Other features it has are grid-like shadows in ground glass lesions, thickening signs of diseased vessels, air bronchi signs and halo signs. The severe disease involves whole bilateral lungs, showing white lung signs, air bronchograms can be seen, and there can be a small amount of pleural effusion in the bilateral chest cavity. At the same time, this year's flu season could be near its peak after surging throughout the United States for months. Chest CT for Influenza infection is characterized by focal ground glass shadows in the lungs, with or without patchy consolidation, and bronchiole air bronchograms are visible in the concentration. There are patchy ground-glass shadows, consolidation, air bronchus signs, mosaic lung perfusion, etc. The lesions are mostly fused, which is prominent near the hilar and two lungs. Grid-like shadows and small patchy ground-glass shadows are visible. Deep neural networks have great potential in image analysis and diagnosis that traditional machine learning algorithms do not. Method: Aiming at the two major infectious diseases COVID-19 and influenza, which are currently circulating in the world, the chest CT of patients with two infectious diseases is classified and diagnosed using deep learning algorithms. The residual network is proposed to solve the problem of network degradation when there are too many hidden layers in a deep neural network (DNN). The proposed deep residual system (ResNet) is a milestone in the history of the Convolutional neural network (CNN) images, which solves the problem of difficult training of deep CNN models. Many visual tasks can get excellent results through fine-tuning ResNet. The pre-trained convolutional neural network ResNet is introduced as a feature extractor, eliminating the need to design complex models and time-consuming training. Fastai is based on Pytorch, packaging best practices for in-depth learning strategies, and finding the best way to handle diagnoses issues. Based on the one-cycle approach of the Fastai algorithm, the classification diagnosis of lung CT for two infectious diseases is realized, and a higher recognition rate is obtained. Results: A deep learning model was developed to efficiently identify the differences between COVID-19 and influenza using chest CT.

Keywords: COVID-19, Fastai, influenza, transfer network

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234 Evaluation of Computed Tomographic Anatomy of Respiratory System in Caspian Pond Turtle (Mauremys caspica)

Authors: Saghar Karimi, Mohammad Saeed Ahrari Khafi, Amin Abolhasani Foroughi

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In recent decades, keeping exotic species as pet animals has become widespread. Turtles are exotic species from chelonians, which are interested by many people. Caspian pond and European pond turtles from Emydidea family are commonly kept as pets in Iran. Presence of the shell in turtles makes achievement to a comprehensive clinical examination impossible. Respiratory system is one of the most important structures to be examined completely. Presence of the air in the respiratory system makes radiography the first modality to think of; however, image quality would be affected by the shell. Computed tomography (CT) as a radiography-based and non-invasive technique provides cross-sectional scans with little superimposition. The aim of this study was to depict normal computed tomographic anatomy of the respiratory system in Caspian Pond Turtle. Five adult Caspian pond turtle were scanned using a 16-detector CT machine. Our results showed that computed tomography is able to well illustrated different parts of respiratory system in turtle and can be used for detecting abnormalities and disorders.

Keywords: anatomy, computed tomography, respiratory system, turtle

Procedia PDF Downloads 173
233 Improving Chest X-Ray Disease Detection with Enhanced Data Augmentation Using Novel Approach of Diverse Conditional Wasserstein Generative Adversarial Networks

Authors: Malik Muhammad Arslan, Muneeb Ullah, Dai Shihan, Daniyal Haider, Xiaodong Yang

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Chest X-rays are instrumental in the detection and monitoring of a wide array of diseases, including viral infections such as COVID-19, tuberculosis, pneumonia, lung cancer, and various cardiac and pulmonary conditions. To enhance the accuracy of diagnosis, artificial intelligence (AI) algorithms, particularly deep learning models like Convolutional Neural Networks (CNNs), are employed. However, these deep learning models demand a substantial and varied dataset to attain optimal precision. Generative Adversarial Networks (GANs) can be employed to create new data, thereby supplementing the existing dataset and enhancing the accuracy of deep learning models. Nevertheless, GANs have their limitations, such as issues related to stability, convergence, and the ability to distinguish between authentic and fabricated data. In order to overcome these challenges and advance the detection and classification of CXR normal and abnormal images, this study introduces a distinctive technique known as DCWGAN (Diverse Conditional Wasserstein GAN) for generating synthetic chest X-ray (CXR) images. The study evaluates the effectiveness of this Idiosyncratic DCWGAN technique using the ResNet50 model and compares its results with those obtained using the traditional GAN approach. The findings reveal that the ResNet50 model trained on the DCWGAN-generated dataset outperformed the model trained on the classic GAN-generated dataset. Specifically, the ResNet50 model utilizing DCWGAN synthetic images achieved impressive performance metrics with an accuracy of 0.961, precision of 0.955, recall of 0.970, and F1-Measure of 0.963. These results indicate the promising potential for the early detection of diseases in CXR images using this Inimitable approach.

Keywords: CNN, classification, deep learning, GAN, Resnet50

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232 Association of Musculoskeletal and Radiological Features with Clinical and Serological Findings in Systemic Sclerosis: A Single-Centre Registry Study

Authors: Nasrin Azarbani

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. Correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. Median age (IQR) was 47.0 years (16), and 52% had diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) was associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low haematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: sclerosis, disease subsets, joint erosion, musculoskeletal

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231 Balanced Ischemia Misleading to a False Negative Myocardial Perfusion Imaging (Stress) Test

Authors: Devam Sheth

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Nuclear imaging with stress myocardial perfusion (stress test) is the preferred first line investigation for noninvasive evaluation of ischaemic heart condition. The sensitivity of this test is close to 90 % making it a very reliable test. However, rarely it gives a false negative result which can be explained by the phenomenon termed as “balanced ischaemia”. We present the case of a 78 year Caucasian female without any significant past cardiac history, who presents with chest pain and shortness of breath since one day. The initial ECG and cardiac enzymes were non-impressive. Few hours later, she had some substernal chest pain along with some ST segment depression in the lateral leads. Stress test comes back negative for any significant perfusion defects. However, given her typical symptoms, she underwent a cardiac catheterization which revealed significant triple vessel disease mandating her to get a bypass surgery. This unusual phenomenon of false nuclear stress test in the setting of positive ECG changes can be explained only by balanced ischemia wherein due to global myocardial ischemia, the stress test fails to reveal relative perfusion defects in the affected segments.

Keywords: balanced, false positive, ischemia, myocardial perfusion imaging

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230 Using Machine Learning to Classify Different Body Parts and Determine Healthiness

Authors: Zachary Pan

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Our general mission is to solve the problem of classifying images into different body part types and deciding if each of them is healthy or not. However, for now, we will determine healthiness for only one-sixth of the body parts, specifically the chest. We will detect pneumonia in X-ray scans of those chest images. With this type of AI, doctors can use it as a second opinion when they are taking CT or X-ray scans of their patients. Another ad-vantage of using this machine learning classifier is that it has no human weaknesses like fatigue. The overall ap-proach to this problem is to split the problem into two parts: first, classify the image, then determine if it is healthy. In order to classify the image into a specific body part class, the body parts dataset must be split into test and training sets. We can then use many models, like neural networks or logistic regression models, and fit them using the training set. Now, using the test set, we can obtain a realistic accuracy the models will have on images in the real world since these testing images have never been seen by the models before. In order to increase this testing accuracy, we can also apply many complex algorithms to the models, like multiplicative weight update. For the second part of the problem, to determine if the body part is healthy, we can have another dataset consisting of healthy and non-healthy images of the specific body part and once again split that into the test and training sets. We then use another neural network to train on those training set images and use the testing set to figure out its accuracy. We will do this process only for the chest images. A major conclusion reached is that convolutional neural networks are the most reliable and accurate at image classification. In classifying the images, the logistic regression model, the neural network, neural networks with multiplicative weight update, neural networks with the black box algorithm, and the convolutional neural network achieved 96.83 percent accuracy, 97.33 percent accuracy, 97.83 percent accuracy, 96.67 percent accuracy, and 98.83 percent accuracy, respectively. On the other hand, the overall accuracy of the model that de-termines if the images are healthy or not is around 78.37 percent accuracy.

Keywords: body part, healthcare, machine learning, neural networks

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229 Associated Risks of Spontaneous Lung Collapse after Shoulder Surgery: A Literature Review

Authors: Fiona Bei Na Tan, Glen Wen Kiat Ho, Ee Leen Liow, Li Yin Tan, Sean Wei Loong Ho

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Background: Shoulder arthroscopy is an increasingly common procedure. Pneumothorax post-shoulder arthroscopy is a rare complication. Objectives: Our aim is to highlight a case report of pneumothorax post shoulder arthroscopy and to conduct a literature review to evaluate the possible risk factors associated with developing a pneumothorax during or after shoulder arthroscopy. Case Report: We report the case of a 75-year-old male non-smoker who underwent left shoulder arthroscopy without regional anaesthesia and in the left lateral position. The general anaesthesia and surgery were uncomplicated. The patient was desaturated postoperatively and was found to have a pneumothorax on examination and chest X-ray. A chest tube drain was inserted promptly into the right chest. He had an uncomplicated postoperative course. Methods: PubMed Medline and Cochrane database search was carried out using the terms shoulder arthroplasty, pneumothorax, pneumomediastinum, and subcutaneous emphysema. We selected full-text articles written in English. Results: Thirty-two articles were identified and thoroughly reviewed. Based on our inclusion and exclusion criteria, 14 articles, which included 20 cases of pneumothorax during or after shoulder arthroscopy, were included. Eighty percent (16/20) of pneumothoraxes occurred postoperatively. In the articles that specify the side of pneumothorax, 91% (10/11) occur on the ipsilateral side of the arthroscopy. Eighty-eight percent (7/8) of pneumothoraxes occurred when subacromial decompression was performed. Fifty-six percent (9/16) occurred in patients placed in the lateral decubitus position. Only 30% (6/20) occurred in current or ex-smokers, and only 25% (5/20) had a pre-existing lung condition. Overall, of the articles that posit a mechanism, 75% (9/12) deem the pathogenesis to be multifactorial. Conclusion: The exact mechanism of pneumothorax is currently unknown. Awareness of this complication and timely recognition are important to prevent life-threatening sequelae. Surgeons should have a low threshold to obtain diagnostic plain radiographs in the event of clinical suspicion.

Keywords: rotator cuff repair, decompression, pressure, complication

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228 Detection of Curvilinear Structure via Recursive Anisotropic Diffusion

Authors: Sardorbek Numonov, Hyohun Kim, Dongwha Shin, Yeonseok Kim, Ji-Su Ahn, Dongeun Choi, Byung-Woo Hong

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The detection of curvilinear structures often plays an important role in the analysis of images. In particular, it is considered as a crucial step for the diagnosis of chronic respiratory diseases to localize the fissures in chest CT imagery where the lung is divided into five lobes by the fissures that are characterized by linear features in appearance. However, the characteristic linear features for the fissures are often shown to be subtle due to the high intensity variability, pathological deformation or image noise involved in the imaging procedure, which leads to the uncertainty in the quantification of anatomical or functional properties of the lung. Thus, it is desired to enhance the linear features present in the chest CT images so that the distinctiveness in the delineation of the lobe is improved. We propose a recursive diffusion process that prefers coherent features based on the analysis of structure tensor in an anisotropic manner. The local image features associated with certain scales and directions can be characterized by the eigenanalysis of the structure tensor that is often regularized via isotropic diffusion filters. However, the isotropic diffusion filters involved in the computation of the structure tensor generally blur geometrically significant structure of the features leading to the degradation of the characteristic power in the feature space. Thus, it is required to take into consideration of local structure of the feature in scale and direction when computing the structure tensor. We apply an anisotropic diffusion in consideration of scale and direction of the features in the computation of the structure tensor that subsequently provides the geometrical structure of the features by its eigenanalysis that determines the shape of the anisotropic diffusion kernel. The recursive application of the anisotropic diffusion with the kernel the shape of which is derived from the structure tensor leading to the anisotropic scale-space where the geometrical features are preserved via the eigenanalysis of the structure tensor computed from the diffused image. The recursive interaction between the anisotropic diffusion based on the geometry-driven kernels and the computation of the structure tensor that determines the shape of the diffusion kernels yields a scale-space where geometrical properties of the image structure are effectively characterized. We apply our recursive anisotropic diffusion algorithm to the detection of curvilinear structure in the chest CT imagery where the fissures present curvilinear features and define the boundary of lobes. It is shown that our algorithm yields precise detection of the fissures while overcoming the subtlety in defining the characteristic linear features. The quantitative evaluation demonstrates the robustness and effectiveness of the proposed algorithm for the detection of fissures in the chest CT in terms of the false positive and the true positive measures. The receiver operating characteristic curves indicate the potential of our algorithm as a segmentation tool in the clinical environment. This work was supported by the MISP(Ministry of Science and ICT), Korea, under the National Program for Excellence in SW (20170001000011001) supervised by the IITP(Institute for Information and Communications Technology Promotion).

Keywords: anisotropic diffusion, chest CT imagery, chronic respiratory disease, curvilinear structure, fissure detection, structure tensor

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227 High-Resolution Computed Tomography Imaging Features during Pandemic 'COVID-19'

Authors: Sahar Heidary, Ramin Ghasemi Shayan

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By the development of new coronavirus (2019-nCoV) pneumonia, chest high-resolution computed tomography (HRCT) has been one of the main investigative implements. To realize timely and truthful diagnostics, defining the radiological features of the infection is of excessive value. The purpose of this impression was to consider the imaging demonstrations of early-stage coronavirus disease 2019 (COVID-19) and to run an imaging base for a primary finding of supposed cases and stratified interference. The right prophetic rate of HRCT was 85%, sensitivity was 73% for all patients. Total accuracy was 68%. There was no important change in these values for symptomatic and asymptomatic persons. These consequences were besides free of the period of X-ray from the beginning of signs or interaction. Therefore, we suggest that HRCT is a brilliant attachment for early identification of COVID-19 pneumonia in both symptomatic and asymptomatic individuals in adding to the role of predictive gauge for COVID-19 pneumonia. Patients experienced non-contrast HRCT chest checkups and images were restored in a thin 1.25 mm lung window. Images were estimated for the existence of lung scratches & a CT severity notch was allocated separately for each patient based on the number of lung lobes convoluted.

Keywords: COVID-19, radiology, respiratory diseases, HRCT

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226 Catamenial Pneumothorax: Report of Two Cases and Review of the Local Literature

Authors: Angeli Marie P. Lagman, Nephtali M. Gorgonio

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Catamenial pneumothorax is defined as a recurrent accumulation of air in the pleural cavity, which occurs in the period of 72 hours before or after menses. In a menstruating woman presenting with the difficulty of breathing and chest pain with concomitant radiographic evidence of pneumothorax, a diagnosis of catamenial pneumothorax should be entertained. Two cases of catamenial pneumothorax were reported in our local literature. This report added two more cases. The first case is 45 years old G1P1, while the second case is 46 years old G2P2. These two patients had a history of pelvic endometriosis in the past. All other signs and symptoms were similar to the previously reported cases. All patients presented with difficulty of breathing associated with chest pain. Imaging studies showed right-sided pneumothorax in all patients. Intraoperatively, subpleural bleb, diaphragmatic fenestrations, and endometriotic implants were found. Three patients underwent video-assisted thoracosurgery (VATS), while one patient underwent open thoracotomy with pleurodesis. Histopathology revealed endometriosis in only two patients. All patients received postoperative hormonal therapy, and there were no recurrences noted in all patients. Endometriosis-related catamenial pneumothorax is a rare condition that needs early recognition of the symptoms. Several theories may be involved to explain the pathogenesis of catamenial pneumothorax. Two cases show a strong significant association between a history of pelvic endometriosis and the development of catamenial pneumothorax, while one case can be explained by the hormonal theory. The difficulty of breathing and chest pain in relation to menses may prompt early diagnosis. One case has shown that pneumothorax may occur even after menstruation. A biopsy of the endometrial implants may not always show endometrial glands and stroma, nor will immunostaining, which will not always show estrogen and progesterone receptors. Video-assisted thoracoscopic surgery is the gold standard in the diagnosis and treatment of catamenial pneumothorax. Postoperative hormonal suppression will further reduce the disease recurrence and facilitate the effectiveness of the surgical treatment.

Keywords: catamenial pneumothorax, endometriosis, menstruation, video assisted thoracosurgery

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225 Covid Medical Imaging Trial: Utilising Artificial Intelligence to Identify Changes on Chest X-Ray of COVID

Authors: Leonard Tiong, Sonit Singh, Kevin Ho Shon, Sarah Lewis

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Investigation into the use of artificial intelligence in radiology continues to develop at a rapid rate. During the coronavirus pandemic, the combination of an exponential increase in chest x-rays and unpredictable staff shortages resulted in a huge strain on the department's workload. There is a World Health Organisation estimate that two-thirds of the global population does not have access to diagnostic radiology. Therefore, there could be demand for a program that could detect acute changes in imaging compatible with infection to assist with screening. We generated a conventional neural network and tested its efficacy in recognizing changes compatible with coronavirus infection. Following ethics approval, a deidentified set of 77 normal and 77 abnormal chest x-rays in patients with confirmed coronavirus infection were used to generate an algorithm that could train, validate and then test itself. DICOM and PNG image formats were selected due to their lossless file format. The model was trained with 100 images (50 positive, 50 negative), validated against 28 samples (14 positive, 14 negative), and tested against 26 samples (13 positive, 13 negative). The initial training of the model involved training a conventional neural network in what constituted a normal study and changes on the x-rays compatible with coronavirus infection. The weightings were then modified, and the model was executed again. The training samples were in batch sizes of 8 and underwent 25 epochs of training. The results trended towards an 85.71% true positive/true negative detection rate and an area under the curve trending towards 0.95, indicating approximately 95% accuracy in detecting changes on chest X-rays compatible with coronavirus infection. Study limitations include access to only a small dataset and no specificity in the diagnosis. Following a discussion with our programmer, there are areas where modifications in the weighting of the algorithm can be made in order to improve the detection rates. Given the high detection rate of the program, and the potential ease of implementation, this would be effective in assisting staff that is not trained in radiology in detecting otherwise subtle changes that might not be appreciated on imaging. Limitations include the lack of a differential diagnosis and application of the appropriate clinical history, although this may be less of a problem in day-to-day clinical practice. It is nonetheless our belief that implementing this program and widening its scope to detecting multiple pathologies such as lung masses will greatly assist both the radiology department and our colleagues in increasing workflow and detection rate.

Keywords: artificial intelligence, COVID, neural network, machine learning

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224 Pulmonary Hydatid Cyst in a 13-Year-Old Child: A Case Report

Authors: Ghada Esheba, Bayan Hafiz, Ashwaq Al-Qarni, Abdulelah AlMalki, Esraa Kaheel

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Hydatid disease is caused by genus Echinococcus, it is transmitted to human through sheep and cattle. People who lived in an endemic area should be suspected to have the disease. Pulmonary hydatid disease can be presented by respiratory manifestations as in our case. We report a case of child, 13 years old, who was presented by shortness of breath and non-productive cough 2 months ago. The patient had an attack of hemoptysis 3 months ago but there is no history of fever, other constitutional symptoms or any medical illness. The patient has had a close contact with a horse. On examination, the patient was oriented and vitally stable. Both side of chest were moving equally with decrease air entry on the left side of the chest. Cervical lymph node enlargement was also detected. The case was provisionally diagnosed as tuberculosis. The x-ray was normal, while CT scan showed two cysts in the left side. The patient was treated surgically with resection of both cysts without lobectomy. Broncho-alveolar lavage was done and together with plural effusion and both cysts were sent for histopathology. The patient received the following medication: albendazole 200MG/BID/Orally for 30 days and Cefuroxime 250MG/Q12H/Orally for 10 days.

Keywords: Echinococcus granulosus, hydatid disease, pediatrics, pulmonary hydatid cyst

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223 Effective Budget Utilization for the Production of Better Health Professionals

Authors: Tesfahiwot Abay Weldearegay

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Ethiopian Federal ministry of health, in collaboration with different partners, provides financial support from sustainable development grants and global fund budget sources to Regional health science colleges through the regional health bureau to improve the quality of training and avail professionals based on the regional health bureau demand from the year of 2012 to 2019EC. It was mainly focused on health extension workers (HEW) Level III&IV, Health Information technicians (HIT), Emergency Medical technicians (EMT), laboratory technicians, Pharmacy technicians, Anesthesia Level V, Radiography, midwifery, Environmental health and biomedical equipment technician. Laboratory technician, Radiography and Pharmacy technician, was retooling program. The study aims at assessing the Utilization and outcome of budgets transferred through regional health bureau to regional health science colleges. The study used both quantitative and qualitative approaches to develop sufficient data to explain the utilization of the budget, and outcomes obtained from the transferred budget and to identify the gaps. The data for the study were obtained through structured questionnaires and interviews was conducted to increase the reliability of the data. Nationally, students enrolled in different disciplines at RHSC through budget support for RHB to improve the quality of training were 87 840 students and the total Budget transferred, according to MOU was 895,752,038 Ethiopian birr. Among the students enrolled nationally in different disciplines at RHSC through budget support only 72% of students have graduated from different disciplines. In Hareri and Addis Ababa, all enrolled students were graduated (100%). At the same time, Oromia 69%, Amara 77%, SNNP 58% students graduated, respectively. The demand of the regional health bureau and the enrollment capacity of health science colleges increased from year to year. The financial support added great value to the HSCs to cop with problems related to student fees, skill lab materials and renovation.

Keywords: emergency medical technician, radiography, Biomedical, health extension

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222 Optimizing Pediatric Pneumonia Diagnosis with Lightweight MobileNetV2 and VAE-GAN Techniques in Chest X-Ray Analysis

Authors: Shriya Shukla, Lachin Fernando

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Pneumonia, a leading cause of mortality in young children globally, presents significant diagnostic challenges, particularly in resource-limited settings. This study presents an approach to diagnosing pediatric pneumonia using Chest X-Ray (CXR) images, employing a lightweight MobileNetV2 model enhanced with synthetic data augmentation. Addressing the challenge of dataset scarcity and imbalance, the study used a Variational Autoencoder-Generative Adversarial Network (VAE-GAN) to generate synthetic CXR images, improving the representation of normal cases in the pediatric dataset. This approach not only addresses the issues of data imbalance and scarcity prevalent in medical imaging but also provides a more accessible and reliable diagnostic tool for early pneumonia detection. The augmented data improved the model’s accuracy and generalization, achieving an overall accuracy of 95% in pneumonia detection. These findings highlight the efficacy of the MobileNetV2 model, offering a computationally efficient yet robust solution well-suited for resource-constrained environments such as mobile health applications. This study demonstrates the potential of synthetic data augmentation in enhancing medical image analysis for critical conditions like pediatric pneumonia.

Keywords: pneumonia, MobileNetV2, image classification, GAN, VAE, deep learning

Procedia PDF Downloads 43
221 Accuracy of Computed Tomography Dose Monitor Values: A Multicentric Study in India

Authors: Adhimoolam Saravana Kumar, K. N. Govindarajan, B. Devanand, R. Rajakumar

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The quality of Computed Tomography (CT) procedures has improved in recent years due to technological developments and increased diagnostic ability of CT scanners. Due to the fact that CT doses are the peak among diagnostic radiology practices, it is of great significance to be aware of patient’s CT radiation dose whenever a CT examination is preferred. CT radiation dose delivered to patients in the form of volume CT dose index (CTDIvol) values, is displayed on scanner monitors at the end of each examination and it is an important fact to assure that this information is accurate. The objective of this study was to estimate the CTDIvol values for great number of patients during the most frequent CT examinations, to study the comparison between CT dose monitor values and measured ones, as well as to highlight the fluctuation of CTDIvol values for the same CT examination at different centres and scanner models. The output CT dose indices measurements were carried out on single and multislice scanners for available kV, 5 mm slice thickness, 100 mA and FOV combination used. The 100 CT scanners were involved in this study. Data with regard to 15,000 examinations in patients, who underwent routine head, chest and abdomen CT were collected using a questionnaire sent to a large number of hospitals. Out of the 15,000 examinations, 5000 were head CT examinations, 5000 were chest CT examinations and 5000 were abdominal CT examinations. Comprehensive quality assurance (QA) was performed for all the machines involved in this work. Followed by QA, CT phantom dose measurements were carried out in South India using actual scanning parameters used clinically by the hospitals. From this study, we have measured the mean divergence between the measured and displayed CTDIvol values were 5.2, 8.4, and -5.7 for selected head, chest and abdomen procedures for protocols as mentioned above, respectively. Thus, this investigation revealed an observable change in CT practices, with a much wider range of studies being performed currently in South India. This reflects the improved capacity of CT scanners to scan longer scan lengths and at finer resolutions as permitted by helical and multislice technology. Also, some of the CT scanners have used smaller slice thickness for routine CT procedures to achieve better resolution and image quality. It leads to an increase in the patient radiation dose as well as the measured CTDIv, so it is suggested that such CT scanners should select appropriate slice thickness and scanning parameters in order to reduce the patient dose. If these routine scan parameters for head, chest and abdomen procedures are optimized than the dose indices would be optimal and lead to the lowering of the CT doses. In South Indian region all the CT machines were routinely tested for QA once in a year as per AERB requirements.

Keywords: CT dose index, weighted CTDI, volumetric CTDI, radiation dose

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220 Free Fibular Flaps in Management of Sternal Dehiscence

Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

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Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

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219 Visibility of the Borders of the Mandibular Canal: A Comparative in Vitro Study Using Digital Panoramic Radiography, Reformatted Panoramic Radiography and Cross Sectional Cone Beam Computed Tomography

Authors: Keerthilatha Pai, Sakshi Kamra

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Objectives: Determining the position of the mandibular canal prior to implant placement and surgeries of the posterior mandible are important to avoid the nerve injury. The visibility of the mandibular canal varies according to the imaging modality. Although panoramic radiography is the most common, slowly cone beam computed tomography is replacing it. This study was conducted with an aim to determine and compare the visibility of superior and inferior borders of the mandibular canal in digital panoramic radiograph, reformatted panoramic radiograph and cross-sectional images of cone beam computed tomography. Study design: digital panoramic, reformatted panoramic radiograph and cross sectional CBCT images of 25 human mandibles were evaluated for the visibility of the superior and inferior borders of the mandibular canal according to a 5 point scoring criteria. Also, the canal was evaluated as completely visible, partially visible and not visible. The mean scores and visibility percentage of all the imaging modalities were determined and compared. The interobserver and intraobserver agreement in the visualization of the superior and inferior borders of the mandibular canal were determined. Results: The superior and inferior borders of the mandibular canal were completely visible in 47% of the samples in digital panoramic, 63% in reformatted panoramic and 75.6% in CBCT cross-sectional images. The mandibular canal was invisible in 24% of samples in digital panoramic, 19% in reformatted panoramic and 2% in cross-sectional CBCT images. Maximum visibility was seen in Zone 5 and least visibility in Zone 1. On comparison of all the imaging modalities, CBCT cross-sectional images showed better visibility of superior border in Zones 2,3,4,6 and inferior border in Zones 2,3,4,6. The difference was statistically significant. Conclusion: CBCT cross-sectional images were much superior in the visualization of the mandibular canal in comparison to reformatted and digital panoramic radiographs. The inferior border was better visualized in comparison to the superior border in digital panoramic imaging. The mandibular canal was maximumly visible in posterior one-third region of the mandible and the visibility decreased towards the mental foramen.

Keywords: cone beam computed tomography, mandibular canal, reformatted panoramic radiograph, visualization

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218 An Approach for Vocal Register Recognition Based on Spectral Analysis of Singing

Authors: Aleksandra Zysk, Pawel Badura

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Recognizing and controlling vocal registers during singing is a difficult task for beginner vocalist. It requires among others identifying which part of natural resonators is being used when a sound propagates through the body. Thus, an application has been designed allowing for sound recording, automatic vocal register recognition (VRR), and a graphical user interface providing real-time visualization of the signal and recognition results. Six spectral features are determined for each time frame and passed to the support vector machine classifier yielding a binary decision on the head or chest register assignment of the segment. The classification training and testing data have been recorded by ten professional female singers (soprano, aged 19-29) performing sounds for both chest and head register. The classification accuracy exceeded 93% in each of various validation schemes. Apart from a hard two-class clustering, the support vector classifier returns also information on the distance between particular feature vector and the discrimination hyperplane in a feature space. Such an information reflects the level of certainty of the vocal register classification in a fuzzy way. Thus, the designed recognition and training application is able to assess and visualize the continuous trend in singing in a user-friendly graphical mode providing an easy way to control the vocal emission.

Keywords: classification, singing, spectral analysis, vocal emission, vocal register

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217 Uncommon Presentation of Iscahemic Heart Disease with Sheehan’s Syndrome at Mid-Level Private Hospital of Bangladesh and Its Management- A Case Report

Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

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216 Current Applications of Artificial Intelligence (AI) in Chest Radiology

Authors: Angelis P. Barlampas

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Learning Objectives: The purpose of this study is to inform briefly the reader about the applications of AI in chest radiology. Background: Currently, there are 190 FDA-approved radiology AI applications, with 42 (22%) pertaining specifically to thoracic radiology. Imaging findings OR Procedure details Aids of AI in chest radiology1: Detects and segments pulmonary nodules. Subtracts bone to provide an unobstructed view of the underlying lung parenchyma and provides further information on nodule characteristics, such as nodule location, nodule two-dimensional size or three dimensional (3D) volume, change in nodule size over time, attenuation data (i.e., mean, minimum, and/or maximum Hounsfield units [HU]), morphological assessments, or combinations of the above. Reclassifies indeterminate pulmonary nodules into low or high risk with higher accuracy than conventional risk models. Detects pleural effusion . Differentiates tension pneumothorax from nontension pneumothorax. Detects cardiomegaly, calcification, consolidation, mediastinal widening, atelectasis, fibrosis and pneumoperitoneum. Localises automatically vertebrae segments, labels ribs and detects rib fractures. Measures the distance from the tube tip to the carina and localizes both endotracheal tubes and central vascular lines. Detects consolidation and progression of parenchymal diseases such as pulmonary fibrosis or chronic obstructive pulmonary disease (COPD).Can evaluate lobar volumes. Identifies and labels pulmonary bronchi and vasculature and quantifies air-trapping. Offers emphysema evaluation. Provides functional respiratory imaging, whereby high-resolution CT images are post-processed to quantify airflow by lung region and may be used to quantify key biomarkers such as airway resistance, air-trapping, ventilation mapping, lung and lobar volume, and blood vessel and airway volume. Assesses the lung parenchyma by way of density evaluation. Provides percentages of tissues within defined attenuation (HU) ranges besides furnishing automated lung segmentation and lung volume information. Improves image quality for noisy images with built-in denoising function. Detects emphysema, a common condition seen in patients with history of smoking and hyperdense or opacified regions, thereby aiding in the diagnosis of certain pathologies, such as COVID-19 pneumonia. It aids in cardiac segmentation and calcium detection, aorta segmentation and diameter measurements, and vertebral body segmentation and density measurements. Conclusion: The future is yet to come, but AI already is a helpful tool for the daily practice in radiology. It is assumed, that the continuing progression of the computerized systems and the improvements in software algorithms , will redder AI into the second hand of the radiologist.

Keywords: artificial intelligence, chest imaging, nodule detection, automated diagnoses

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215 Effect of Operative Stabilization on Rib Fracture Healing in Porcine Experimental Model: A Pilot Study

Authors: Maria Stepankova, Lucie Vistejnova, Pavel Klein, Tereza Blassova, Marketa Slajerova, Radek Sedlacek, Martin Bartos, Jaroslav Chlupac

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Background: Clinical outcome benefits of the segment rib fracture surgical therapy are well known and follow from better stabilization of the chest wall. Despite this, some authors still incline to conservative therapy and point out to possible rib fracture healing failure in connection with the bone vascular supply disturbance caused by metal plate implantation. This suggestion met neither experimental nor clinical verification and remains the object of discussion. In our pilot study we investigated the titanium plate fixation effect on the rib fracture healing in porcine model and its histological, biomechanical and radiological aspects. Materials and Method: Two porcine models (experimental group) underwent the operative chest wall stabilization with a titanium plate implantation after osteotomy. Two other porcine models (control group) were treated conservatively after osteotomy. Three weeks after surgery, all animals were sacrificed, treated ribs were explanted and the histological analysis, µCT imaging and biomechanical testing of the calluses tissue were performed. Results: In µCT imaging, experimental group showed a higher cortical bone volume compared to the control group. Histological analysis using the non-decalcified bone tissue blocks demonstrated more maturated callus with higher newly-formed osseous tissue ratio in experimental group in comparison to controls. In contrast, no significant differences in bone blood vessels supply in both groups were observed. This finding suggests that the bone blood supply in experimental group was not impaired. Biomechanical analysis using 3-point bending test demonstrated significantly higher bending stiffness and the maximum force in experimental group. Conclusion: Based on our observation, it could be concluded, that the titanium plate fixation of the rib fractures leads to faster bone callus maturation whereas does not cause the vascular supply impairment after 3 weeks and thus has a beneficial effect on the rib fracture healing.

Keywords: bone vascular supply, chest wall stabilization, fracture healing, histological analysis, titanium plate implantation

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214 Comparison of EMG Normalization Techniques Recommended for Back Muscles Used in Ergonomics Research

Authors: Saif Al-Qaisi, Alif Saba

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Normalization of electromyography (EMG) data in ergonomics research is a prerequisite for interpreting the data. Normalizing accounts for variability in the data due to differences in participants’ physical characteristics, electrode placement protocols, time of day, and other nuisance factors. Typically, normalized data is reported as a percentage of the muscle’s isometric maximum voluntary contraction (%MVC). Various MVC techniques have been recommended in the literature for normalizing EMG activity of back muscles. This research tests and compares the recommended MVC techniques in the literature for three back muscles commonly used in ergonomics research, which are the lumbar erector spinae (LES), latissimus dorsi (LD), and thoracic erector spinae (TES). Six healthy males from a university population participated in this research. Five different MVC exercises were compared for each muscle using the Tringo wireless EMG system (Delsys Inc.). Since the LES and TES share similar functions in controlling trunk movements, their MVC exercises were the same, which included trunk extension at -60°, trunk extension at 0°, trunk extension while standing, hip extension, and the arch test. The MVC exercises identified in the literature for the LD were chest-supported shoulder extension, prone shoulder extension, lat-pull down, internal shoulder rotation, and abducted shoulder flexion. The maximum EMG signal was recorded during each MVC trial, and then the averages were computed across participants. A one-way analysis of variance (ANOVA) was utilized to determine the effect of MVC technique on muscle activity. Post-hoc analyses were performed using the Tukey test. The MVC technique effect was statistically significant for each of the muscles (p < 0.05); however, a larger sample of participants was needed to detect significant differences in the Tukey tests. The arch test was associated with the highest EMG average at the LES, and also it resulted in the maximum EMG activity more often than the other techniques (three out of six participants). For the TES, trunk extension at 0° was associated with the largest EMG average, and it resulted in the maximum EMG activity the most often (three out of six participants). For the LD, participants obtained their maximum EMG either from chest-supported shoulder extension (three out of six participants) or prone shoulder extension (three out of six participants). Chest-supported shoulder extension, however, had a larger average than prone shoulder extension (0.263 and 0.240, respectively). Although all the aforementioned techniques were superior in their averages, they did not always result in the maximum EMG activity. If an accurate estimate of the true MVC is desired, more than one technique may have to be performed. This research provides additional MVC techniques for each muscle that may elicit the maximum EMG activity.

Keywords: electromyography, maximum voluntary contraction, normalization, physical ergonomics

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213 Slovenia in the Heart of Europe

Authors: M. Žibert, T. Špindler, S. Uhan, A. Lisec

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We can find Slovenia in the heart of Europe and has really good geographical location. With same slogan are promoted Switzerland, Montenegro, Greece and probably many others. However, from anatomic point of view, injustice is being made to someone because the heart is placed only in left part of chest cavity and there we can`t find place for the entire territory from Switzerland to the south of Balkan.

Keywords: Ljubljana, logistics, Slovenia, tourism

Procedia PDF Downloads 350
212 Clinical Features of Acute Aortic Dissection Patients Initially Diagnosed with ST-Segment Elevation Myocardial Infarction

Authors: Min Jee Lee, Young Sun Park, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Jae Ho Lee, Yoon Seon Lee, Kyung Soo Lim, Won Young Kim

Abstract:

Background: Acute myocardial infarction (AMI) concomitant with acute aortic syndrome (AAS) is rare but prompt recognition of concomitant AAS is crucial, especially in patients with ST-segment elevation myocardial infarction (STEMI) because misdiagnosis with early thrombolytic or anticoagulant treatment may result in catastrophic consequences. Objectives: This study investigated the clinical features of patients of STEMI concomitant with AAS that may lead to the diagnostic clue. Method: Between 1 January 2010 and 31 December 2014, 22 patients who were the initial diagnosis of acute coronary syndrome (AMI and unstable angina) and AAS (aortic dissection, intramural hematoma and ruptured thoracic aneurysm) in our emergency department were reviewed. Among these, we excluded 10 patients who were transferred from other hospital and 4 patients with non-STEMI, leaving a total of 8 patients of STEMI concomitant with AAS for analysis. Result: The mean age of study patients was 57.5±16.31 years and five patients were Standford type A and three patients were type B aortic dissection. Six patients had ST-segment elevation in anterior leads and two patients had in inferior leads. Most of the patients had acute onset, severe chest pain but no patients had dissecting nature chest pain. Serum troponin I was elevated in three patients but all patients had D-dimer elevation. Aortic regurgitation or regional wall motion abnormality was founded in four patients. However, widened mediastinum was seen in all study patients. Conclusion: When patients with STEMI have elevated D-dimer and widened mediastinum, concomitant AAS may have to be suspected.

Keywords: aortic dissection, myocardial infarction, ST-segment, d-dimer

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211 Automatic Classification of Lung Diseases from CT Images

Authors: Abobaker Mohammed Qasem Farhan, Shangming Yang, Mohammed Al-Nehari

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Pneumonia is a kind of lung disease that creates congestion in the chest. Such pneumonic conditions lead to loss of life of the severity of high congestion. Pneumonic lung disease is caused by viral pneumonia, bacterial pneumonia, or Covidi-19 induced pneumonia. The early prediction and classification of such lung diseases help to reduce the mortality rate. We propose the automatic Computer-Aided Diagnosis (CAD) system in this paper using the deep learning approach. The proposed CAD system takes input from raw computerized tomography (CT) scans of the patient's chest and automatically predicts disease classification. We designed the Hybrid Deep Learning Algorithm (HDLA) to improve accuracy and reduce processing requirements. The raw CT scans have pre-processed first to enhance their quality for further analysis. We then applied a hybrid model that consists of automatic feature extraction and classification. We propose the robust 2D Convolutional Neural Network (CNN) model to extract the automatic features from the pre-processed CT image. This CNN model assures feature learning with extremely effective 1D feature extraction for each input CT image. The outcome of the 2D CNN model is then normalized using the Min-Max technique. The second step of the proposed hybrid model is related to training and classification using different classifiers. The simulation outcomes using the publically available dataset prove the robustness and efficiency of the proposed model compared to state-of-art algorithms.

Keywords: CT scan, Covid-19, deep learning, image processing, lung disease classification

Procedia PDF Downloads 115