Do central vestibular findings predict abnormal findings on magnetic resonance imaging?

2019 ◽  
Vol 133 (7) ◽  
pp. 554-559
Author(s):  
G Mankekar ◽  
G Jeha ◽  
I Erbele ◽  
M Klumpp ◽  
A Sevy ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Age Groups ◽  
Cerebellar Atrophy ◽  
Case Series ◽  
Resonance Imaging ◽  
Retrospective Case ◽  
Tertiary Referral Centre

AbstractObjectiveTo determine whether central findings from vestibular tests predict abnormal findings on magnetic resonance imaging.MethodThis study was a retrospective case series at a tertiary referral centre. The main outcome measure of this diagnostic intervention study was the positive predictive value of central vestibular findings in relation to magnetic resonance imaging abnormalities.ResultsCentral vestibular findings had a 50.9 per cent positive predictive value for magnetic resonance imaging abnormalities across all age groups although they varied according to age group. Optokinetic nystagmus (p < 0.05) and abnormal findings on videonystagmography tests (p < 0.05) were the main predictors of magnetic resonance imaging abnormalities. White matter lesions constituted the bulk of the central lesions on magnetic resonance imaging followed by cortical and cerebellar atrophy.ConclusionCentral vestibular findings had a 50.9 per cent positive predictive value for magnetic resonance imaging abnormalities across all age groups. Magnetic resonance imaging is medically justified to further evaluate patients with central findings on vestibular studies. Therefore, it is reasonable to request magnetic resonance imaging in these patients.

Incidental mastoiditis on magnetic resonance imaging scans: clinical relevance and cost implications

2018 ◽  
Vol 132 (11) ◽  
pp. 1010-1012 ◽  
Author(s):  
Y Abbas ◽  
H S Yuen ◽  
A Trinidade ◽  
G Watters
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Incidental Finding ◽  
Case Series ◽  
Resonance Imaging ◽  
Retrospective Case ◽  
Reporting Practice ◽  
Significant Pathology ◽  
Cost Implications ◽  
Rule Out

AbstractObjectivesTo determine: (1) the incidence of incidental ‘mastoiditis’ reported on magnetic resonance imaging scans performed in patients with asymmetrical sensorineural hearing loss and/or unilateral tinnitus; (2) how many of those patients have actual otological pathology and/or require treatment; and (3) the financial implications of such a reporting practice.MethodRetrospective case series.ResultsBetween October 2015 and November 2016, 500 patients underwent magnetic resonance imaging of the internal auditory meatus to rule out cerebellopontine angle lesions. There was an incidental finding of increased mastoid signalling in 5.8 per cent (n= 29), of which 20.7 per cent (6 of 29) were reported as bilateral cases. The diagnosis of ‘mastoiditis’ was found in 39.7 per cent (29 of 73). None of these patients had any pathology identified clinically. Other significant pathology was identified in a further 8.8 per cent (n= 44).ConclusionThe diagnosis of mastoiditis is primarily clinical. An incidental finding of high signalling in the mastoid region on magnetic resonance imaging is highly unlikely to represent actual clinical disease. In patients who are scanned for other reasons and who do not complain of otological symptoms, such findings are unlikely to require otolaryngology input.

scholarly journals Correlation of clinical examination, ultrasound, magnetic resonance imaging and arthroscopy as diagnostic tools in shoulder pathology

2020 ◽  
Vol 6 (2) ◽  
pp. 247
Author(s):  
Sondipon Biswas ◽  
Naman Kanodia ◽  
Rajat Tak ◽  
Siddharth Agrawal ◽  
Kiran Shankar Roy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Shoulder Arthroscopy ◽  
Resonance Imaging ◽  
Shoulder Pathologies

<p class="abstract"><strong>Background:</strong> Shoulder pathologies can cause significant pain, discomfort, and affect the activity of daily living. The aim of this study was to compare the efficacy of clinical examination, ultrasound, magnetic resonance imaging (MRI) with shoulder arthroscopy in diagnosing various shoulder pathologies, considering shoulder arthroscopy as the gold standard tool.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, comparative study conducted over 35 patients, between 18-75 years of age presenting with chronic shoulder pain or instability of more than 2 months duration. All patients were examined clinically, followed by high resolution ultrasound, MRI, arthroscopy of the affected shoulder.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sensitivity and specificity of ultrasonography (USG) for diagnosing full thickness tear was 100% each and for MRI was 88% and 100% respectively. For subacromial impingement USG had sensitivity of 66.67%, specificity of 94.12%, positive predictive value of 50% and negative predictive value of 88.89%. For rotator cuff tear USG had sensitivity of 92.86%, specificity of 50%, positive predictive value of 81.25% and negative predictive value of 75% considering shoulder arthroscopy as gold standard.</p><p class="abstract"><strong>Conclusions:</strong> USG and MRI both are sensitive techniques for diagnosing of rotator cuff pathologies. USG has high accuracy in diagnosing partial thickness tears as compare to MRI. MRI proved to be superior in estimation of site and extent of tear. Considering shoulder arthroscopy as gold standard, it can be reserved for patients with suspicious of USG/MRI findings or those who may need surgical intervention simultaneously.</p>

Audiologist-led screening of acoustic neuromas in patients with asymmetrical sensorineural hearing loss and/or unilateral tinnitus: our experience in 1126 patients

2018 ◽  
Vol 132 (9) ◽  
pp. 786-789
Author(s):  
Y Abbas ◽  
G Smith ◽  
A Trinidade
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hearing Loss ◽  
Magnetic Resonance ◽  
Sensorineural Hearing Loss ◽  
Acoustic Neuroma ◽  
Case Series ◽  
Cost Savings ◽  
Sensorineural Hearing ◽  
Resonance Imaging ◽  
Tertiary Referral Centre

AbstractObjectiveTo determine whether patients within an otolaryngology department presenting with asymmetrical sensorineural hearing loss and/or unilateral tinnitus can be safely and cost-efficiently screened for acoustic neuroma by audiologists as a first or only point of contact.MethodsA prospective case series and cost analysis were conducted at a tertiary referral centre. Between April 2013 and March 2017, 1126 adult patients presented to the audiology department with asymmetrical sensorineural hearing loss and/or unilateral tinnitus. All were screened for acoustic neuroma with magnetic resonance imaging, based on pre-determined criteria. The main outcome measure was the presence of acoustic neuroma or other pathology on magnetic resonance imaging.ResultsTwenty-five patients (2.22 per cent) were found to have an acoustic neuroma (size range: 3–20 mm) and were referred to the otolaryngologist for further assessment. The remaining patients were appropriately managed and discharged by the audiologists without ENT input. This resulted in an overall cost saving of £164 850.ConclusionPatients with asymmetrical sensorineural hearing loss and/or unilateral tinnitus can be safely screened for acoustic neuroma and independently managed by audiologists as a first or only point of contact, resulting in considerable departmental cost savings.

The Crank Test, the O'Brien Test, and Routine Magnetic Resonance Imaging Scans in the Diagnosis of Labral Tears

2002 ◽  
Vol 30 (6) ◽  
pp. 806-809 ◽  
Author(s):  
William B. Stetson ◽  
Kevin Templin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Shoulder Arthroscopy ◽  
Rotator Cuff Tears ◽  
Resonance Imaging ◽  
Routine Magnetic Resonance Imaging ◽  
Labral Tears

Background Tears of the superior labrum of the shoulder, anterior to posterior, are difficult to diagnose clinically. Purpose We examined whether the crank or O'Brien tests were reliable tools for detecting glenoid labral tears. Study Design Nonrandomized prospective study. Methods Results of diagnostic shoulder arthroscopy were compared with those of the preoperative tests and magnetic resonance imaging for 65 patients who had symptoms of shoulder pain. Results The crank test result was positive in 29 patients (45%), and the O'Brien test was positive in 41 patients (63%). The crank test had a positive predictive value of 41%, was 56% specific, 46% sensitive, and had a negative predictive value of 61%. The O'Brien test had a positive predictive value of 34%, was 31% specific, 54% sensitive, and had a negative predictive value of 50%. Magnetic resonance imaging had a positive predictive value of 63%, was 92% specific, 42% sensitive, and had a negative predictive value of 83%. Conclusions The O'Brien and crank tests were not sensitive clinical indicators for detecting glenoid labral tears and other tears of the anterior and posterior labrum. Results were often falsely positive for patients with other shoulder conditions, including impingement or rotator cuff tears.

The Diagnostic Accuracy of Magnetic Resonance Imaging and Ultrasonography in Gluteal Tendon Tears -A Systematic Review

2011 ◽  
Vol 21 (6) ◽  
pp. 637-645 ◽  
Author(s):  
Daniel J. Westacott ◽  
Jonathon I. Minns ◽  
Pedro Foguet
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Imaging Modality ◽  
High Signal ◽  
Diagnostic Strategy ◽  
Resonance Imaging ◽  
Trochanteric Bursitis ◽  
Tendon Tears

Gluteal tendon tears are one of the many pathologies causing pain around the greater trochanter that are often labelled as trochanteric bursitis. We systematically reviewed the peer-reviewed literature to establish the accuracy of magnetic resonance imaging and ultrasonography in the diagnosis of gluteal tendon tears in patients with persistent lateral hip pain or Greater Trochanteric Pain Syndrome (GTPS). 7 studies met the inclusion criteria, comparing either imaging modality with a reference standard of surgical findings. Included studies were assessed for methodological quality using the QUADAS checklist. MRI had sensitivity of 33–100%, specificity of 92–100%, positive predictive value of 71–100% and negative predictive value of 50%. False-positives were common. High signal located superior to the trochanter had a stronger association with tears. Ultrasonography had a sensitivity of 79–100% and positive predictive value of 95–100%. The amount and quality of literature on the subject is limited and further well-designed studies are required to establish the optimum diagnostic strategy in this condition. Ultrasonography may prove to be the investigation of choice, despite requiring a skilled practitioner. The orthopaedic surgeon should liaise with an experienced musculoskeletal radiologist to best investigate and diagnose gluteal tendon tears in the clinical picture of GTPS.

scholarly journals Echocardiography as a Screening Test for Myocardial Scarring in Children with Hypertrophic Cardiomyopathy

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Gregory Compton ◽  
Lynne Nield ◽  
Andreea Dragulescu ◽  
Lee Benson ◽  
Lars Grosse-Wortmann
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Screening Test ◽  
Resonance Imaging ◽  
Myocardial Scarring ◽  
Echocardiographic Evidence

Introduction. Hypertrophic cardiomyopathy (HCM) is burdened with morbidity and mortality including tachyarrhythmias and sudden cardiac death. These complications are attributed in part to the formation of proarrhythmic scars in the myocardium. The presence of extensive LGE is a risk factor for adverse outcomes in HCM. Late gadolinium enhancement (LGE) cardiac magnetic resonance imaging (cMRI) is the standard for the noninvasive evaluation of myocardial scars. However, echocardiography represents an attractive screening tool for myocardial scarring. The aim of this study was to compare the suitability of echocardiography to detect myocardial scars to the standard of cMRI-LGE.Methods. The cMRI studies and echocardiograms from 56 consecutive children with HCM were independently evaluated for the presence of cMRI-LGE and echocardiographic evidence of scarring by expert readers.Results. Echocardiography had a high sensitivity (93%) and negative predictive value (94%) in comparison to LGE. The false positive rate was high, leading to a low specificity (37%) and a low positive predictive value (35%).Conclusions. Given the poor specificity and positive predictive value, echocardiography is not a suitable screening test for the presence of myocardial scarring in children with HCM. However, children without echocardiographic evidence of myocardial scarring may not need to undergo cardiac magnetic resonance imaging to “rule in” LGE.

scholarly journals Positive Predictive Value of Magnetic Resonance Imaging in Intradural Spinal Tumors Taking Histopathology as Gold Standard

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
HAFEEZ-UR -REHMAN ◽  
ADNAN YOUSAF ◽  
MUHAMMAD USMAN ◽  
MUHAMMAD NOUMAN AKRAM
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Radiology Department ◽  
Resonance Imaging ◽  
Female Ratio

Objective: To observe the positive predictive value of MRI, taking histopathology as gold standard in detecting spinal intradural tumors.Materials and Methods: Total 180 cases were included through non-probability purposive sampling, at Ganga Ram Hospital, Radiology department, Lahore. The radiological diagnosis obtained through MRI, was observed. The cases fit in inclusion criteria were underwent surgery and their histopathological findings were observed. Comparison between the outcomes of MRI and histopathology were undertaken, keeping histopathology as gold  standard. Positive predictive value of MRI in the diagnosis of intradural spinal tumor was calculated andpresented in the form of percentages and frequency.Results: There were total 180 patients presenting in OPD with the mean age of 45.71 ± 13.57 years. There were 112 (62%) male. Male to female ratio was 1.6:1. There were 134 (74.4%) cases who were positive for malignant spinal intradural tumor on histopathology showing the PPV of MRI as 74.4%.Conclusion: Magnetic Resonance Imaging is very beneficial imaging tool for early diagnosis of spinal cord tumors.

Sensitivity and positive predictive value of magnetic resonance imaging in the diagnosis of elastofibroma dorsi: review of fourteen cases

2013 ◽  
Vol 22 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Iskandar Tamimi Mariño ◽  
Pedro Sesma Solis ◽  
Almudena Pérez Lara ◽  
Javier Martinez Malo ◽  
Maria luz Vazquez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Elastofibroma Dorsi
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