rib fracture
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2021 ◽  
Author(s):  
Junzhong Zhang ◽  
Zhiwei Li ◽  
Shixing Yan ◽  
Hui Cao ◽  
Jing Liu ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Liding Yao ◽  
Xiaojun Guan ◽  
Xiaowei Song ◽  
Yanbin Tan ◽  
Chun Wang ◽  
...  

AbstractRib fracture detection is time-consuming and demanding work for radiologists. This study aimed to introduce a novel rib fracture detection system based on deep learning which can help radiologists to diagnose rib fractures in chest computer tomography (CT) images conveniently and accurately. A total of 1707 patients were included in this study from a single center. We developed a novel rib fracture detection system on chest CT using a three-step algorithm. According to the examination time, 1507, 100 and 100 patients were allocated to the training set, the validation set and the testing set, respectively. Free Response ROC analysis was performed to evaluate the sensitivity and false positivity of the deep learning algorithm. Precision, recall, F1-score, negative predictive value (NPV) and detection and diagnosis were selected as evaluation metrics to compare the diagnostic efficiency of this system with radiologists. The radiologist-only study was used as a benchmark and the radiologist-model collaboration study was evaluated to assess the model’s clinical applicability. A total of 50,170,399 blocks (fracture blocks, 91,574; normal blocks, 50,078,825) were labelled for training. The F1-score of the Rib Fracture Detection System was 0.890 and the precision, recall and NPV values were 0.869, 0.913 and 0.969, respectively. By interacting with this detection system, the F1-score of the junior and the experienced radiologists had improved from 0.796 to 0.925 and 0.889 to 0.970, respectively; the recall scores had increased from 0.693 to 0.920 and 0.853 to 0.972, respectively. On average, the diagnosis time of radiologist assisted with this detection system was reduced by 65.3 s. The constructed Rib Fracture Detection System has a comparable performance with the experienced radiologist and is readily available to automatically detect rib fracture in the clinical setting with high efficacy, which could reduce diagnosis time and radiologists’ workload in the clinical practice.


2021 ◽  
Vol 268 ◽  
pp. 25-32
Author(s):  
Kathrine A. Kelly-Schuette ◽  
Anthony Prentice ◽  
Adam Orr ◽  
Anna Levine ◽  
Allison Zarnke ◽  
...  
Keyword(s):  

2021 ◽  
pp. 000313482110505
Author(s):  
John R. Murfee ◽  
Kaitlin E. Pardue ◽  
Paige. Farley ◽  
Nathan M. Polite ◽  
Maryann I. Mbaka ◽  
...  

Traumatic blunt diaphragm injuries are a diagnostic challenge in trauma. They may be missed due to the increasing trend of non-operative management of patients. The purpose of this study was to review the rate of occult blunt diaphragm injuries in patients who underwent video assisted thoracic surgery (VATS) for rib fixation. This retrospective study included patients that received VATS as part of our institutional protocol for rib fracture management. This includes utilizing incentive spirometry, multimodal analgesia, and early consideration for VATS. Data was abstracted from the electronic medical record and included demographics, operative findings, and outcomes. Thirty patients received VATS per our rib fracture protocol. No patients had any identified diaphragm injury on pre-operative imaging. A concomitant diaphragm injury was identified in 20% (6/30) of the study population. All patients were alive at 30 days. For all patients, total hospital length of stay was 14.5 days, ICU length of stay was 8.9 days, and average ventilator days was 4.2 days. When comparing patients with and without concomitant diaphragm injuries, hospital length of stay was 16.8 days vs. 14.5 ( P = 0.59), ICU length of stay was 11.8 days vs. 8.2 ( P = 0.54), and ventilator days was 4.5 days vs. 4.2 ( P = 0.93). This study revealed that 20% of patients undergoing VATS for rib fracture fixation had a concomitant diaphragm injury. This higher-than-expected prevalence suggests that groups of patients sustaining blunt trauma may have occult diaphragmatic injuries that are otherwise unidentified. This raises the need for improved diagnostic modalities to identify these injuries.


Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1896
Author(s):  
Yu Jin Im ◽  
Min Soo Kang ◽  
Sun Woong Kim ◽  
Duk Hyun Sung

In cardiac surgery, median sternotomy is often necessary during certain surgical processes and it can cause the rare complication of brachial plexus injury. Retraction of the rib cage during median sternotomy may produce a fracture of the first thoracic rib at the costovertebral junction which might penetrate or irritate the lower root of the brachial plexus. Because the C8 ventral root is located immediately superior to the first thoracic rib, the extraforaminal C8 root is thought to be the key location of brachial plexus injury by the first rib fracture. This report describes three cases of brachial plexus injury after median sternotomy in a single center. In our cases, fracture of the first rib and consequent brachial plexus injury is confirmed with imaging and electrophysiologic studies. The fracture of the first rib is not detected with standard plain images and it is confirmed only with CT or MRI studies. Advanced imaging tools are recommended to assess the first rib fracture when brachial plexus injury is suspected after median sternotomy.


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