Comparison of diagnostic value of multidetector computed tomography and X-ray in the detection of body packing

Background: Abdominal tuberculosis (ATB) is a rare form of extra-pulmonary tuberculosis which is clinically challenging. It remains difficult to diagnose due to the non-specific presentation, variable anatomical location and lack of sensitive diagnostic tools. To evaluate the diagnostic value of computed tomography (CT) in the patients of abdominal tuberculosis.Methods: This was a retrospective diagnostic study design. The study was conducted among adults aged>18 years of either gender with clinical suspected ATB. The detailed demographic and clinical history was noted on pre-designed proforma. After obtaining the history, the patient was subjected to general physical and systematic examinations. The patients were then subjected to radiological evaluation that included chest X-ray, X-ray of abdomen and CT.Results: A total of 55 clinically suspected adult cases of abdominal tuberculosis were enrolled in the study. 45 (81.8%) were found to be abdominal tuberculosis on final diagnosis. The abdominal tuberculosis was found to be higher in the age groups 21-40 years (64.4%).The abdominal tuberculosis was observed to be higher among female patients (62.2%) than males (37.8%). CT findings showed that the bowel wall thickening & narrowing and dilatation was found in 64.4% patients.Conclusions: ATB is still a diagnosis to consider in individuals presenting with abdominal symptoms in the developing world, particularly in patients from ethnic minorities. Diagnosis can be challenging and requires a multidisciplinary approach with involvement from Radiology, Microbiology, Gastroenterology, Surgery, Infectious Diseases and Respiratory teams.

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Diagnostic value of multidetector computed tomography in differentiation of benign and malignant omental lesions

The Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1016/j.ejrnm.2015.02.003 ◽

2015 ◽

Vol 46 (2) ◽

pp. 305-314

Author(s):

Alsiagy A. Salama ◽

Aly Aly Elbarbary ◽

Mohamed Hamdy Aboryia

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Diagnostic Value

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Value of Multidetector Computed Tomography in the Assessment of Achalasia Subtypes and Detection of Pulmonary and Thoracic Complications

Medical Principles and Practice ◽

10.1159/000501057 ◽

2019 ◽

Vol 28 (6) ◽

pp. 539-546

Author(s):

Sanja Jovanovic ◽

Aleksandra Djuric-Stefanovic ◽

Aleksandar Simić ◽

Ognjan Skrobic ◽

Predrag Pesko

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Wall Thickness ◽

Imaging Modality ◽

Correlation Coefficients ◽

Observer Agreement ◽

Esophageal Wall ◽

X Ray ◽

Chest X Ray ◽

Diagnostic Work

Objective: To evaluate multidetector computed tomography (MDCT) findings in patients with achalasia, to assess its role in differentiating subtypes in detecting lung involvement and extra-esophageal thoracic complications. Subjects and Methods: This clinical retrospective study included 51 patients with manometrically confirmed achalasia who underwent chest X-ray and MDCT in diagnostic work-up. Esophageal wall thickness and morphology, luminal dilatation, lung changes, and extra-esophageal manifestations were analyzed on MDCT by 2 readers. Wilcoxon, Kruskal-Wallis and Mann-Whitney test were used for assessing the differences among the achalasia subtypes, and intra-class correlation coefficients (ICC) assessing the inter-observer agreement between the measurements of 2 readers. Results: Fourteen (27.5%) patients had achalasia subtype I, 21 (60.8%) had subtype II while 6 (11.8%) had subtype III. Esophageal wall thickness of the esophageal body (EB) and distal esophageal segment (DES) as well as nodular/lobulated appearance of DES were found significantly more often in subtype III (p = 0.024, p < 0.001, p = 0.009, respectively). Esophageal dilatation gradually decreased from subtype I to III (p = 0.006). Chest X-ray revealed lung changes in 9 (17%) and MDCT in 21 (41%) patients (p = 0.001), most frequently in subtype I, with predominance of ground-glass opacities. Tracheal/carinal compression was detected in 27 (52.9%) and left atrial compression in 17 (33.3%) patients. Excellent inter-observer agreement was observed in measuring the EB and DES wall thickness, and diameter of EB (ICC 0.829, 0.901, and 0.922). Conclusion: MDCT is a useful tool for detecting lung and extra-esophageal thoracic complications in patients with achalasia, and could be a valuable additional imaging modality in the differentiation of achalasia subtypes.

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