PubMed · 7467044
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N L Beleshov. 1980. [Improved Böhler splint].. https://pubmed.ncbi.nlm.nih.gov/7467044/
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OBJECTIVE: This study compared conventional thoracic and skeletal radiographs with 12-bit digitized images of the same radiographs in terms of subjective image quality and accuracy of diagnosis of subtle disease. MATERIALS AND METHODS: Thirty-six chest radiographs with normal findings, 48 chest radiographs with abnormal findings, 29 skeletal radiographs with normal findings, and 26 skeletal radiographs with abnormal findings were included in this study. The images were chosen for the subtlety of their findings (nodules, pneumothoraces, interstitial lung disease, fractures). Each set of images was laser-digitized and viewed independently by three radiologists at a teleradiology workstation with a 1280 x 1024 pixel matrix monitor equipped with an eight-bit-per-pixel gray-scale display. All images were viewed at maximum resolution. After review of the digitized images for image quality and for the presence of abnormalities, each radiologist analyzed the analog images in a similar way. RESULTS: Sensitivities for detecting nodules, pneumothoraces, and interstitial lung disease on digitized chest radiographs were 58%, 75%, and 90%, respectively, compared with 62%, 79%, and 92%, respectively, on the original radiographs. Sensitivity for fracture detection on digitized bone radiographs was 87% compared with 88% on analog radiographs. None of these differences was statistically significant. CONCLUSION: Digitization of radiographs for primary diagnosis by teleradiology results in a slight decrease in sensitivity for detection of subtle abnormalities, provided that the images are viewed at maximum resolution.
Management of intraperitoneal, nonurethral bladder injuries by urinary diversion using suprapubic (SP) catheters versus transurethral (TU) Foley catheters was examined retrospectively in a attempt to determine which were most effective. A total of 8500 trauma admissions (6/89-1/96) were screened for bladder injuries. Mechanism, degree, treatment, and morbidity of injury in association with SP or TU Foley catheter placement were evaluated. Of the total of 70 bladder injuries identified, the diagnosis in 40 patients (57%) whose injuries resulted from blunt trauma was made by cystogram (55%), CT scan alone (15%), or by exploration (30%). Of these, 22 patients (55%) were treated nonoperatively with a TU catheter for extraperitoneal extravasation or partial bladder wall laceration. Gunshot wounds accounted for 43 per cent (30 patients); of these patients, all but one had celiotomies and bladder repair. SP catheters were placed in three blunt trauma patients, preoperatively in 1 patient, and intraoperatively in 17 patients who had sustained penetrating trauma. A total of 50 patients (71%), 27 with repair and TU catheter and 23 with TU catheter alone, were treated without an SP catheter. All bladder or urethral morbidity occurred in the SP group (35%): 3 strictures, 2 urinary retentions, 1 SP infection, and 1 urinary infection. Degree of bladder injury was no different with or without an SP catheter. No urethral strictures, urinary tract infections, or retention occurred in isolated bladder injuries treated with TU catheters alone. Average SP and TU catheter duration was 42 and 13 days, respectively. TU catheters for management of blunt and penetrating bladder trauma are effective, cause fewer strictures and less morbidity, and may be removed more rapidly than SP catheters for any degree of bladder injury.