Evaluation of imaging quality of X-ray films of endemic fluorosis in Shandong Province

Abstract

Objective To evaluate the photo quality of X-ray films of endemic fluorosis in Shandong Province,and to provide a basis for correct implementation of X-ray examination.Methods Three villages were selected as survey sites in each of the 20 endemic fluorosis counties (cities,districts) of Shandong Province;anteroposterior X-ray films of the villagers forearm(including elbow) and leg(including knee) were taken; 20 films were taken in each village,each film comprising two recording sites.X-ray examination carried out in the 42 patients' villages of 14 counties(cities,districts) were undertaken by the Institute for Endemic Disease Control,Shandong Province,a total of 840 X-ray films shoot,which was edited group A,and the remaining six counties (cities,districts) were undertaken by the local Hospital,shooting X-ray films 360 copies,compiled for group B.The quality of X-ray film examination was determined in accordance with technical requirements and diagnostic indicators.The difference of photo quality between group A and group B was compared at three levels:sub-surface defects photos,structural defects and comprehensive quality.Results In evaluation of surface defects in the photo,the total detection rate of the defects indicators in group A of forearm was 7.98％(67/840),while the rate of leg was 9.77％(82/840).And the rates of group B were 35.27％(127/360) and 39.16％(141/360),respectively,and the differences were statistically significant between the two groups(x2forearm=138.6,P ＜ 0.01 ; x2leg =144.0,P ＜ 0.01).In assessment of structural defects,the total forearm defection rate of group A was 7.14％(60/840),and the leg was 8.33％ (70/840).And the rates of group B were 27.22％ (98/360) and 31.38％ (113/360),respectively.The differences were statistically significant(x2forearm =88.867,P ＜ 0.01; x2leg =103.6,P ＜ 0.01).In the photo quality comprehensive assessment,the excellent rate of forearm in group A was 72.73％(611/840),and the leg was 71.67％ (602/840),while the poor quality rates in the same parts were 9.89％ (83/840) and 11.43％ (96/840),respectively.And the excellent rates of Group B were 44.14％(159/360) and 42.22％(152/360),poor quality rates were 34.74％(125/360) and 38.06％(137/360).The differences were statistically significant(Z value were-20.161 and-16.229,respectively,P ＜ 0.01).Conclusions X-ray films taken in the counties (cities,districts) have more defects,and image is poor.The reason for that is that the skill levels of local hospital X-ray technician are low,and photos quality is not strictly followed requirements.Supervision team of professional technicians should be established to provide professional supports.It is more important to take mobile X-ray examination by the provincial institutes,and to provide a reliable technical support. Key words: Fluoride poisoning; Osteofluorosis; X-ray