Correlations between the abnormal development of the skull base and facial skeleton growth in anterior synostotic plagiocephaly: the predictive value of a classification based on CT scan examination

2011 ◽  
Vol 27 (9) ◽  
pp. 1431-1443 ◽  
Author(s):  
Sandro Pelo ◽  
Giampiero Tamburrini ◽  
Tito Matteo Marianetti ◽  
Gianmarco Saponaro ◽  
Alessandro Moro ◽  
...  
Keyword(s):  
Ct Scan ◽  
Skull Base ◽  
Predictive Value ◽  
Abnormal Development ◽  
Facial Skeleton

scholarly journals A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatemeh Khatami ◽  
Mohammad Saatchi ◽  
Seyed Saeed Tamehri Zadeh ◽  
Zahra Sadat Aghamir ◽  
Alireza Namazi Shabestari ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcriptase ◽  
Ct Scan ◽  
Predictive Value ◽  
Meta Analysis ◽  
Chest Ct ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Chest Ct Scan

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.

scholarly journals The role of CT imaging for management of COVID-19 in epidemic area: early experience from a University Hospital

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Vikram rao Bollineni ◽  
Koenraad Hans Nieboer ◽  
Seema Döring ◽  
Nico Buls ◽  
Johan de Mey
Keyword(s):  
Ct Scan ◽  
Predictive Value ◽  
Ct Imaging ◽  
Chest Ct ◽  
University Hospital ◽  
Rt Pcr ◽  
Ct Findings ◽  
Epidemic Area ◽  
Chest Ct Scan ◽  
Pcr Test

Abstract Background To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19 patients. Methods From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus. Results Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97–100%, 144/240), 28% (95% CI: 19–38%, 27/240), 68% (95% CI: 65–70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65–77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive. Conclusion Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19 infection.

Atypical Form of Cervicofacial Actinomycosis Involving the Skull Base and Temporal Bone

2018 ◽  
Vol 128 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Adam McCann ◽  
Sameer A. Alvi ◽  
Jessica Newman ◽  
Kiran Kakarala ◽  
Hinrich Staecker ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Skull Base ◽  
Temporal Bone ◽  
Soft Tissues ◽  
Trauma Surgery ◽  
Oral Antibiotic ◽  
Facial Skeleton ◽  
Atypical Form ◽  
Unsuccessful Treatment ◽  
The Right

Background: Cervicofacial actinomycosis is an uncommon indolent infection caused by Actinomyces spp that typically affects individuals with innate or adaptive immunodeficiencies. Soft tissues of the face and neck are most commonly involved. Actinomyces osteomyelitis is uncommon; involvement of the skull base and temporal bone is exceedingly rare. The authors present a unique case of refractory cervicofacial actinomycosis with development of skull base and temporal bone osteomyelitis in an otherwise healthy individual. Methods: Case report with literature review. Results: A 69-year-old man presented with a soft tissue infection, culture positive for Actinomyces, over the right maxilla. Previous unsuccessful treatment included local debridement and 6 weeks of intravenous ceftriaxone. He was subsequently treated with conservative debridement and a prolonged course of intravenous followed by oral antibiotic. However, he eventually required multiple procedures, including maxillectomy, pterygopalatine fossa debridement, and a radical mastoidectomy to clear his disease. Postoperatively he was gradually transitioned off intravenous antibiotics. Conclusions: Cervicofacial actinomycosis involves soft tissue surrounding the facial skeleton and oral cavity and is typically associated with a history of mucosal trauma, surgery, or immunodeficiency. The patient was appropriately treated but experienced disease progression and escalation of therapy. Although actinomycosis is typically not an aggressive bacterial infection, this case illustrates the need for prompt recognition of persistent disease and earlier surgical intervention in cases of recalcitrant cervicofacial actinomycosis. Chronic actinomycosis has the potential for significant morbidity.

scholarly journals Role of CT (Computed Tomography) in the Evaluation of Fungal Diseases in Paranasal Sinus

2014 ◽  
Vol 31 (4) ◽  
pp. 189-193
Author(s):  
T Islam ◽  
SA Azad ◽  
ME Karim ◽  
L Khondker ◽  
K Rahman
Keyword(s):  
Fungal Infection ◽  
Ct Scan ◽  
Paranasal Sinus ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Fungal Diseases ◽  
Cross Sectional ◽  
Computed Tomographic ◽  
Histopathological Result

A cross sectional study carried out with patients having suspected paranasal sinus (PNS) mass during January 2009 to October 2010 to evaluate the fungal diseases in PNS by computed tomographic(CT) image and comparison of the findings of this modality with histopathological result. Among the total 76 patients, the mean age of the patients was 35.95 ± 18.24 and common complaints of the patients were nasal obstruction (73.7%) and maximum 53.9% patients had PNS mass in maxillary sinuses. Out of all cases 10 were diagnosed as having fungal infection/mass by CT scan and confirmed by histopathological evaluation. Two cases were diagnosed as having fungal infection/mass by CT scan but not confirmed by histopathological findings. Of 64 cases of other than fungal infection/mass, which were diagnosed by CT scan, six were confirmed as having fungal infection/mass and 58 were other than having fungal infection/mass by histopathology. Sensitivity of CT scan to diagnose fungal infection/mass was 62.5%, specificity 96.7%, positive predictive value 83.3%, negative predictive value 90.6% and accuracy 89.5%. CT scan of the fungal diseases in paranasal sinus provides more information and better image quality and CT diagnosis correlate well with the findings of histopathology. DOI: http://dx.doi.org/10.3329/jbcps.v31i4.21002 J Bangladesh Coll Phys Surg 2013; 31: 189-193

scholarly journals Role of Liver Enzymes in Patients with Blunt Abdominal Trauma to Diagnose Liver Injury

2020 ◽  
Author(s):  
Anup Shrestha ◽  
Harish Chandra Neupane ◽  
Kishor Kumar Tamrakar ◽  
Abhishek Bhattarai ◽  
Gaurav Katwal
Keyword(s):  
Liver Injury ◽  
Confidence Interval ◽  
Ct Scan ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Predictive Value ◽  
Liver Enzymes ◽  
Tertiary Center ◽  
Significant Difference

Abstract Background:The liver is the second most injured organ following blunt abdominal trauma (BAT) after spleen. Although the computed tomography (CT) scan is considered as the gold standard for diagnosing liver injury in BAT, it is not readily available in the hospital. This study was performed to evaluate the role of aspartate transaminase (AST) and alanine transaminase (ALT) in patients with BAT and its significance in predicting the diagnosis and severity of the liver injury.Method:The study was conducted in Chitwan Medical College Teaching Hospital (CMCTH) study from February 2019 to May 2020. During that period 96 patients with BAT presented to the emergency department(ED) of CMCTH.Results:Among the 96 patients admitted with BAT, 38 patients had liver injury and 58 patients had no liver injury. The median length of the intensive care unit (ICU) stay of patients with liver injury was higher than without liver injury. There was a significant difference in the median level of AST and ALT (<0.001) between patients with liver injury and no liver injury. The area under the ROC curve of AST was 0.89(95% Confidence Interval 0.86-0.98) and of ALT was 0.92(95% Confidence Interval 0.83-0.97). The area under the curve demonstrated that the test was a good predictor for the identification of liver injury and also the severity of liver enzymes. The cut-off values for the liver injury were 106 U/l and 80 U/l for AST and ALT respectively. Based on these values, AST ≥ 106 U/l had a sensitivity of 71.7 %, a specificity of 90 %, a positive predictive value of 86.8 %, and a negative predictive value of 77.6 %. The corresponding values for ALT ≥ 80 U/l were 77.8 %, 94.1%, 92.1% and 82.8 %, respectively.ConclusionIn conclusion, we report the optimal cut-off value of AST and ALT for liver injury in BAT as ≥ 106 U/l and 80 U/l respectively. The elevated level of AST and ALT might assist the surgeons to timely refer the suspected patients with the liver to a tertiary center and it might help the surgeons to go for conservative management for minor liver injuries in BAT preventing the exposure hazards of the CT scan.

scholarly journals The Relationship between Risk Factors of Head Trauma with CT Scan Findings in Children with Minor Head Trauma Admitted to Hospital

2017 ◽  
Vol 5 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Babak Masoumi ◽  
Farhad Heydari ◽  
Hamidreza Hatamabadi ◽  
Reza Azizkhani ◽  
Zahra Yoosefian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Ct Scan ◽  
Head Trauma ◽  
Predictive Value ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Normal Brain ◽  
Brain Ct ◽  
Brain Ct Scan

BACKGROUND: In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan.AIMS: The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional.METHODS: We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years. Patient’s CT scan findings and head trauma risk factors were evaluated in this study.RESULTS: Out of 368 patients, 326 patients had normal brain CT scan. 28 of them showed symptoms of ICI consisting intraventricular haemorrhage (IVH), contusion, subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural hematoma (EDH), and pneumocephalus. Twenty-seven patients showed skull FX, which 14 of them had an Isolated fracture, and 13 of them also showed symptoms of ICI. Since patients with isolated FX usually discharge quickly from Emergency Department; their data did not include in results of the study. The patients have been divided into two groups: 1- ICI, 2- without ICI. RR (relative risk), CI (Confidence interval) and sensitivity, positive predictive value (PPV), negative predictive value (NPV) and association of these risk factors with ICI were assessed with the Chi-2 test. In the end to determine the indications of CT scan, the presence of one of these five risk factors is important including abnormal mental status, clinical symptoms of skull FX, history of vomiting, craniofacial soft tissue injury (including subgaleal hematomas or laceration) and headache.CONCLUSIONS: For all other patients without these risk factors, observation and Follow Up can be used which has more advantages and less cost.

scholarly journals EVALUATING THE ROLE OF FDG PET-CT SCAN AS A SOLE IMAGING MODALITY IN THE MANAGEMENT OF MUO NECK

2020 ◽  
pp. 39-41
Author(s):  
Krishnappa Krishnappa ◽  
Krishna Prasad ◽  
Shruti Satish ◽  
Murali R Nadig
Keyword(s):  
Ct Scan ◽  
Predictive Value ◽  
Fdg Pet ◽  
Imaging Modality ◽  
False Negative ◽  
Unknown Primary ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Aim:to study the role of PET- CT SCAN as a single imaging modality in the diagnosis of MUO neck. methodology: retrospective study analysis of 51 cases of clinical unknown primary with cervical metastasis . RESULTS: FDG PET CT tracer uptake was detected in 24/51. true positive in 18 cases out of 24,false positive in 6 cases, false negative in 2 cases with sensitivity of 90%, specificity of 82%,positive predictive value of 75%,negative predictive value of 93% and accuracy of 84.91%. conclusion: FDG PET CT can be used as a sole imaging modality in the diagnosis of MUO neck.it is complimentary to endoscopy.

Ultrasound Detection of Pneumothorax Compared with Chest X-Ray and Computed Tomography Scan

2011 ◽  
Vol 77 (4) ◽  
pp. 480-483 ◽  
Author(s):  
Khanjan Nagarsheth ◽  
Stanley Kurek
Keyword(s):  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Chest Ct ◽  
Trauma Patients ◽  
X Rays ◽  
Thoracic Ultrasound ◽  
X Ray ◽  
Chest X Ray ◽  
Chest Ct Scan

Pneumothorax after trauma can be a life threatening injury and its care requires expeditious and accurate diagnosis and possible intervention. We performed a prospective, single blinded study with convenience sampling at a Level I trauma center comparing thoracic ultrasound with chest X-ray and CT scan in the detection of traumatic pneumothorax. Trauma patients that received a thoracic ultrasound, chest X-ray, and chest CT scan were included in the study. The chest X-rays were read by a radiologist who was blinded to the thoracic ultrasound results. Then both were compared with CT scan results. One hundred and twenty-five patients had a thoracic ultrasound performed in the 24-month period. Forty-six patients were excluded from the study due to lack of either a chest X-ray or chest CT scan. Of the remaining 79 patients there were 22 positive pneumothorax found by CT and of those 18 (82%) were found on ultrasound and 7 (32%) were found on chest X-ray. The sensitivity of thoracic ultrasound was found to be 81.8 per cent and the specificity was found to be 100 per cent. The sensitivity of chest X-ray was found to be 31.8 per cent and again the specificity was found to be 100 per cent. The negative predictive value of thoracic ultrasound for pneumothorax was 0.934 and the negative predictive value for chest X-ray for pneumothorax was found to be 0.792. We advocate the use of chest ultrasound for detection of pneumothorax in trauma patients.

scholarly journals Nuclear Magnetic Resonance Imaging of Skull Base Lesions

1985 ◽  
Vol 12 (S4) ◽  
pp. 327-331 ◽  
Author(s):  
D.G. Potts ◽  
R.D. Zimmerman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Nuclear Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
Skull Base ◽  
Diagnostic Study ◽  
Resonance Imaging ◽  
Basic Principles ◽  
Skull Base Lesions ◽  
Nuclear Magnetic

ABSTRACT:The basic principles of nuclear magnetic resonance (NMR) are reviewed and the appearances of some lesions of the skull base are discussed. NMR is a valuable diagnostic study for skull base lesions and it provides information that is not shown on the CT scan. The modern investigation of unusual skull base lesions should include both CT and NMR.

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