scholarly journals Interobserver variability of ultrasound measurements for the differential diagnosis of uterine prolapse and cervical elongation without uterine prolapse

2021 ◽  
Author(s):  
José Antonio García-Mejido ◽  
Zenaida Ramos Vega ◽  
Alberto Armijo Sánchez ◽  
Ana Fernández-Palacín ◽  
Carlota Borrero Fernández ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Interobserver Variability ◽  
Uterine Prolapse ◽  
Valsalva Maneuver ◽  
Interobserver Reliability ◽  
Ultrasound Images ◽  
Cervical Elongation ◽  
Ultrasound Measurements ◽  
The Difference ◽  
Uterine Fundus

Abstract Objectives Our study aims to determine the interobserver variability of different ultrasound measurements (pubis-cervix distance, pubis-uterine fundus distance, and pubis-Douglascul-de-sac distance) previously analyzed for the ultrasound differential diagnosis of uterine prolapse (UP) and cervical elongation CE without UP. Materials and methods We conducted a prospective observational study with 40 patients scheduled to undergo surgical correction of UP and CE without UP. All patients underwent pelvic floor ultrasound examination by an examiner (E1) who acquired ultrasound images. Using these images, E1 measured the distances for the ultrasound differential diagnosis of UP and CE without UP, and these distances were compared with those measured by the other examiner (E2). Values were analyzed by calculating ICCs with 95% CIs. Results For UP, excellent reliability was obtained for all measurements except the pubis-Douglascul-de-sac measurement at rest, which was moderate (ICC 0.596; p = 0.028) and for the difference between the pubis-Douglascul-de-sac measurement at rest and during the Valsalva maneuver, which was good (ICC 0.691; p < 0.0005). For CE without UP, interobserver reliability was excellent for all measurements analyzed except the pubis-cervix measurement during the Valsalva maneuver, which was moderate (ICC 0.535; p = 0.052) and for the pubis-Douglascul-de-sac measurement at rest, which was good (ICC 0.768; p < 0.0005). Conclusions There is excellent interobserver reliability in measurements of the difference in the distance from the pubic symphysis to the uterine fundus at rest and during the Valsalva maneuver for both UP and CE without UP, which are used for the ultrasound differential diagnosis of UP and CE without UP.

Abstract 308: Cardiac Cycle Affects Ultrasound Measurements of Ascending Aortic Diameter in a Marfan Mouse Model

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Zheying Chen ◽  
Hisashi Sawada ◽  
Debra Rateri ◽  
Alan Daugherty ◽  
Mary Sheppard
Keyword(s):  
Cardiac Cycle ◽  
Interobserver Variability ◽  
Innominate Artery ◽  
Aortic Diameter ◽  
Ultrasound Images ◽  
Anatomical Landmarks ◽  
Wild Type ◽  
Ultrasound Measurements ◽  
Fibrillin 1 ◽  
Ascending Aortic Diameter

Objective: Ultrasound measurements of aortic diameter are a common endpoint in preclinical studies. However, there is a lack of standardization in both image capture and analysis. For our study, we developed a standardized protocol for measuring ascending aortic diameter and examined effects of cardiac cycle in wild type and fibrillin-1 hypomorphic (FBN mgR/mgR ) mice. Methods and Results: Twelve week old male and female FBN mgR/mgR mice were anesthetized and maintained at a heart rate of 450-550 beats per minute. Ultrasound images were captured using a Vevo 2100 system with a 40MHz tranducer. Images captured were standardized according to two anatomical landmarks: the innominate artery branchpoint and aortic valves. The largest luminal ascending aortic diameter between the sinotubular junction and the innominate artery were measured in mid-systole and end-diastole by two blinded, independent observers. Aortic diameters were significantly different (p<0.05) when comparing systole and diastole within gender and genotype. Interestingly, wild-type male (n=4) and female (n=3) mice exhibited a 19% and 15% expansion of the ascending aorta respectively during systole compared to diastole. This difference was not recapitulated in either male (n=6) or female (n=5) FBN mgR/mgR mice (4% expansion in both; p<0.05 vs wild-type). Agreement between observers was excellent (R^2 = 0.99) but interobserver variability was a mean of .09 mm (%CV = 5%) Conclusion: As expected, there is a difference in aortic diameters between wild-type and FBN mgR/mgR mice. Luminal aortic diameters in FBN mgR/mgR vs wild-type mice of both genders are affected by cardiac cycle. Mid-systolic aortic expansion in wild-type vs FBN mgR/mgR mice were different. Error introduced by interobserver variability impacts ascending aortic measurements. Altogether, these phenomena may confound analyses of aortic dilation in FBN mgR/mgR mice, especially when studying interventions with modest effect sizes.

scholarly journals Assessment of reliability and validity of the 5-scale grading system of the point-of-care immunoassay for tear matrix metalloproteinase-9

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Minjeong Kim ◽  
Ja Young Oh ◽  
Seon Ha Bae ◽  
Seung Hyeun Lee ◽  
Won Jun Lee ◽  
...  
Keyword(s):  
Matrix Metalloproteinase ◽  
Calibration Curve ◽  
Point Of Care ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Grading System ◽  
Intraclass Correlation Coefficients ◽  
The Difference

AbstractWe evaluated the reliability and validity of the 5-scale grading system to interpret the point-of-care immunoassay for tear matrix metalloproteinase (MMP)-9. Six observers graded red bands of photographs of the readout window in MMP-9 immunoassay kit (InflammaDry) two times with 2-week interval based on the 5-scale grading system (i.e. grade 0–4). Interobserver and intraobserver reliability were evaluated using intraclass correlation coefficients. The interobserver agreements were analyzed according to the severity of tear MMP-9 expression. To validate the system, a concentration calibration curve was made using MMP-9 solutions with reference concentrations, then the distribution of MMP-9 concentrations was analyzed according to the 5-scale grading system. Both intraobserver and interobserver reliability was excellent. The readout grades were significantly correlated with the quantified colorimetric densities. The interobserver variance of readout grades had no correlation with the severity of the measured densities. The band density continued to increase up to a maximal concentration (i.e. 5000 ng/mL) according to the calibration curve. The difference of grades reflected the change of MMP-9 concentrations sensitively, especially between grade 2 and 4. Together, our data indicate that the subjective 5-scale grading system in the point-of-care MMP-9 immunoassay is an easy and reliable method with acceptable accuracy.

scholarly journals Ultrasonic elastography and conventional ultrasound in the diagnosis of thyroid micro-nodules

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Jinming Wang ◽  
Wenbing Wei ◽  
Rui Guo
Keyword(s):  
Differential Diagnosis ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Ultrasound Elastography ◽  
Surgical Pathology ◽  
Maximum Diameter ◽  
Clinical Value ◽  
Conventional Ultrasound ◽  
Missed Diagnosis ◽  
The Difference

Objective: To investigate the clinical value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules. Methods: Eighty-six patients who were found with thyroid micro-nodules with the maximum diameter no more than 10 mm in the physical examination in our hospital from June 2015 to December 2017 were selected, and 102 nodules were included. All patients were confirmed with thyroid micro-nodules by puncture or surgical pathology and underwent conventional ultrasound and ultrasound elastography. Taking the surgical pathological results as a control, the value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules were compared. A receiver operating characteristic (ROC) curve was drawn, and the area under the ROC curve was calculated. Results: One hundred and two thyroid nodules were detected by surgical pathology, including 75 benign nodules (73.53%) and 27 malignant nodules (26.47%). The sensitivity and diagnostic accordance rate of ultrasound elastography were significantly higher than those of conventional ultrasound in the diagnosis of thyroid microcarcinoma, and the missed diagnosis rate of ultrasound elastography was significantly lower than that of conventional ultrasound; the difference was statistically significant (P<0.05). However, the difference between the two methods was not statistically significant in terms of diagnostic specificity and misdiagnosis rate (P>0.05). The areas under the ROC curve in the diagnosis of benign and malignant thyroid nodules by conventional ultrasound and ultrasound elastography were 0.735 and 0.743 respectively. Conclusion: Conventional ultrasound can be used as a routine examination technique in differential diagnosis of benign and malignant thyroid nodules, while ultrasound elastography can improve the sensitivity and diagnostic rate in the diagnosis of thyroid micro carcinoma. It can help to reduce the clinical missed diagnosis, which also can be be used as an effective supplement for conventional ultrasound. doi: https://doi.org/10.12669/pjms.35.6.777 How to cite this:Wang J, Wei W, Guo R. Ultrasonic elastography and conventional ultrasound in the diagnosis of thyroid micro-nodules. Pak J Med Sci. 2019;35(6):1526-1531. doi: https://doi.org/10.12669/pjms.35.6.777 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

CD10, TDAG51, CK20, AR, INSM1, and Nestin Expression in the Differential Diagnosis of Trichoblastoma and Basal Cell Carcinoma

2018 ◽  
Vol 27 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Cem Leblebici ◽  
Buket Bambul Sığırcı ◽  
Canan Kelten Talu ◽  
Sevim Baykal Koca ◽  
Gülben Erdem Huq
Keyword(s):  
Differential Diagnosis ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
The Other ◽  
Cytokeratin 20 ◽  
Nestin Expression ◽  
The Difference ◽  
Nevus Sebaceous ◽  
Sensitive Marker

Background. Trichoblastoma (TB) and basal cell carcinoma (BCC) are 2 different neoplasms composed of basaloid cells and have overlapping histopathological features. We compared the immunoexpression of CD10, T-cell death-associated gene 51 (TDAG51), cytokeratin 20 (CK20), androgen receptor (AR), insulinoma-associated protein 1 (INSM1), and nestin for the differential diagnosis of these tumors. Materials and Methods. We assessed a total of 27 BCC and 27 TB cases, including 4 TB lesions in nevus sebaceous and 3 malignant TB lesions for CD10, TDAG51, CK20, AR, INSM1, and nestin expression. Results. Staining for CK20, TDAG51, INSM1, and stromal CD10 was significantly more common in TB cases than in BCC cases ( P < .001). Epithelial CD10 and AR staining was significantly more common in BCC cases than in TB cases ( P < .001). The difference between the groups for nestin staining was not significant ( P > .05). Stromal CD10 staining was the most sensitive marker (96.3%) and INSM1 the least sensitive (55.6%) marker for TB. TDAG51 showed 100% specificity for TB. A larger number of CK20 positive cells was found in the cases associated with nevus sebaceous than in the other TBs. Conclusion. All the selected markers except nestin were useful for the differential diagnosis between TB and BCC. CD10 and TDAG51 were more useful than the other markers. The use of CK20 could be preferred in nevus sebaceous lesions. INSM1 was less effective in highlighting Merkel cells within the lesion than CK20.

Fibrinolysis of an Acute Myocarditis Mimicking an Acute Myocardial Infarction

2020 ◽  
Author(s):  
Safir Soukaina
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Differential Diagnosis ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Acute Myocarditis ◽  
Clinical Signs ◽  
Acute Onset ◽  
St Segment Elevation ◽  
The Difference

Background: Acute myocarditis and acute myocardial infarction have frequently similar clinical presentations and poses an important clinical challenge in the differential diagnosis. In both cases, the electrocardiographic ST-T changes and an increase in troponins can be noted. Differential diagnosis may be very challenging and requires invasive assessment of coronary arteries and other investigations especially cardiac magnetic resonance. Case Presentation: In this report, we report a rare case of acute myocarditis misdiagnosed to an acute myocardial infarction in a patient presented to the emergency department for an acute onset of chest pain with ST-segment elevation on electrocardiogram for which he received urgent fibrinolysis. The confirmation of acute myocarditis was confirmed posteriori after a normal coronary angiogram using cardiac Magnetic Resonance Imaging cMRI. Conclusions: Clinical signs as long with Electrocardiogram may mimick a ST elevation myocardial infarction in the presence of an authentic acute myocarditis,Hence, cardiac magnetic resonance could present an intersting tools to make the difference even in acute phase.

Four-Dimensional CT Analysis of Dorsal Intercalated Segment Instability in patients with Suspected Scapholunate Instability

2021 ◽  
Author(s):  
Lionel Athlani ◽  
Jonathan Granero ◽  
Kamel Rouizi ◽  
Gabriela Hossu ◽  
Alain Blum ◽  
...  
Keyword(s):  
Interobserver Variability ◽  
Intraclass Correlation ◽  
Threshold Values ◽  
Level Of Evidence ◽  
Ct Arthrography ◽  
Scapholunate Instability ◽  
Ct Analysis ◽  
The Difference ◽  
Dorsal Intercalated Segment Instability ◽  
Work Up

Abstract Background In this study we sought to evaluate the contribution of dynamic four-dimensional computed tomography (4DCT) relative to the standard imaging work-up for the identification of the dorsal intercalated segment instability (DISI) in patients with suspected chronic scapholunate instability (SLI). Methods Forty patients (22 men, 18 women; mean age 46.5 ± 13.1 years) with suspected SLI were evaluated prospectively with radiographs, arthrography, and 4DCT. Based on radiographs and CT arthrography, three groups were defined: positive SLI (n = 16), negative SLI (n = 19), and questionable SLI (n = 5). Two independent readers used 4DCT to evaluate the lunocapitate angle (LCA) (mean, max, coefficient of variation [CV], and range values) during radioulnar deviation. Results The interobserver variability of the 4DCT variables was deemed excellent (intraclass correlation coefficient = 0.79 to 0.96). Between the three groups, there was no identifiable difference for the LCAmean. The LCAmax values were lower in the positive SLI group (88 degrees) than the negative SLI group (102 degrees). The positive SLI group had significantly lower LCAcv (7% vs. 12%, p = 0.02) and LCArange (18 vs. 27 degrees, p = 0.01) values than the negative SLI group. The difference in all the LCA parameters between the positive SLI group and the questionable SLI group was not statistically significant. When comparing the negative SLI and questionable SLI groups, the LCAcv (p = 0.03) and LCArange (p = 0.02) values were also significantly different. The best differentiation between patients with and without SLI was obtained with a LCAcv and LCArange threshold values of 9% (specificity of 63% and sensitivity of 62%) and 20 degrees (specificity of 71% and sensitivity of 63%), respectively. Conclusion In this study, 4DCT appeared as a quantitative and reproducible relevant tool for the evaluation of DISI deformity in cases of SLI, including for patients presenting with questionable initial radiography findings. Level of evidence This is a Level III study.

Vimentin Reactivity in Renal Oncocytoma: Immunohistochemical Study of 234 Cases

2007 ◽  
Vol 131 (12) ◽  
pp. 1782-1788 ◽  
Author(s):  
Ondrej Hes ◽  
Michal Michal ◽  
Naoto Kuroda ◽  
Guido Martignoni ◽  
Matteo Brunelli ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Renal Cell ◽  
Imaging System ◽  
Large Series ◽  
Renal Tumors ◽  
Renal Oncocytoma ◽  
Renal Cell Carcinomas ◽  
Central Scar ◽  
Renal Oncocytomas ◽  
The Difference

Abstract Context.—The expression of vimentin in benign renal oncocytomas has been controversal. However, this is of clinical significance because immunostains may be used in differential diagnosis of renal tumors on limited biopsy specimens. Using different staining and analysis methods, we studied vimentin immunoreactivity in a large series of renal oncocytomas with a special emphasis on the immunoreactivity patterns. Objective.—Immunohistochemical expression of vimentin has been used in the differential diagnosis of renal epithelial neoplasms. Although typically expressed in most renal cell carcinomas, the immunoreactivity of this intermediate filament in renal oncocytomas has been controversial. Design.—We studied vimentin immunoreactivity in a large series of 234 renal oncocytomas using 2 staining methods as well as manual and automated imaging analyses. Results.—We found that the focal vimentin immunoreactivity can be seen in most (72.6%) renal oncocytomas with vimentin-positive tumor cells usually found in the edge of a central scar or in small clusters scattered throughout the tumor. Computer-aided imaging analysis using ChromaVision Automatic Cellular Imaging System II confirmed the difference in vimentin immunoreactivity between oncocytoma and other renal neoplasms. Conclusions.—Our study of vimentin immunohistochemistry in a series of renal oncocytomas, which to our knowledge is the largest ever published, showed focal vimentin positivity detected in most oncocytomas. Because the vimentin staining patterns in renal oncocytomas are different from those seen in clear cell or papillary renal cell carcinomas, we consider vimentin staining to be helpful in the differential diagnosis of oncocytoma from other renal tumor mimics. Furthermore, strong vimentin positivity in a renal cell neoplasm does not exclude the diagnosis of renal oncocytoma, particularly in a limited biopsy specimen.

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