scholarly journals Extraspinal findings prevalence and clinical significance in 4250 lumbar spine MRI exams

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ruba A. Khasawneh ◽  
Ziyad Mohaidat ◽  
Firas A. Khasawneh ◽  
Ahmad Farah ◽  
Maha Gharaibeh ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Clinical Significance ◽  
Renal Cysts ◽  
Reporting Rate ◽  
Urinary System ◽  
Mri Scans ◽  
Original Report ◽  
Clinically Significant ◽  
Patient’S Outcome ◽  
Spine Mri

AbstractTo assess extraspinal findings (ESFs) prevalence in lumbar spine MRI, including clinically significant findings using a systematic approach, and to determine their reporting rate. Lumbar spine MRI scans were retrospectively reviewed over 18 months by two radiologists. Reading discrepancies were resolved by consensus. ESFs were classified according to the involved system, clinical diagnosis, and clinical significance. The reporting rate was estimated by referring to the original report. There were 1509 ESFs in 1322/4250 patients with a substantial agreement between the two radiologists (kappa = 0.8). Almost half (621/1322) were in the 45–60 age group. Females represented 56.6% (748/1322). 74.2% (1120/1509) of the ESFs involved the urinary system among which 79.6% (892/1120) were renal cysts. Clinically significant findings represented 8.7% (131/1509) among which hydronephrosis represented 23% (30/131). First time detected malignant lesions represented 4.6% (6/131). ESFs reporting rate was 47.3%. 58.8% of the clinically significant ESFs were not reported. ESFs prevalence was 31.1%. The Urinary system was the most commonly involved. Most ESFs were benign warranting no further workup. However, clinically significant ESF were not infrequently detected. More than half of the clinically significant findings were not reported. A systematic review of MRI images is highly recommended to improve patient’s outcome.

How reliable is routine lumbar spine MRI for detection of renal cysts? Correlation with abdominal CT

2015 ◽  
Vol 57 (4) ◽  
pp. 494-499
Author(s):  
Hee Woo Cho ◽  
Young Han Lee ◽  
Soo Yoon Chung ◽  
Jin-Oh Park ◽  
Jin-Suck Suh
Keyword(s):  
Lumbar Spine ◽  
Renal Cysts ◽  
Abdominal Ct ◽  
Spine Mri

Incidental Extra-Spinal Findings in Lumbar Spine MRI: Incidence and Clinical Significance

2015 ◽  
Vol 15 (10) ◽  
pp. S197-S198
Author(s):  
Hassan Semaan ◽  
Tawfik Obri ◽  
Jacob Bieszczad ◽  
Paul Aldinger ◽  
Mohammed Al-Natour ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Clinical Significance ◽  
Spine Mri

Overreporting of the disc herniation in lumbar spine MRI scans performed for patients with spondylolisthesis

2020 ◽  
pp. 028418512092548
Author(s):  
Hassan Semaan ◽  
Bryan Curnutte ◽  
Maxwell Cooper ◽  
Joud Obri ◽  
Mazzin Elsamaloty ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Disc Herniation ◽  
Incidence Rates ◽  
Significant Difference ◽  
Mri Scans ◽  
Group 2 ◽  
Magnetic Resonance Imaging Mri ◽  
Spine Surgeon ◽  
Spine Mri ◽  
Group 1

Background Spondylolisthesis is often misdiagnosed on magnetic resonance imaging (MRI) as the slip may reduce to a normal alignment when the patient lies supine. Often, disc herniation is reported at the level of spondylolisthesis. Purpose To determine the incidence rates of disc herniation at the level of spondylolisthesis. Material and Methods This is a retrospective study included 258 consecutive patients with spondylolisthesis who had lumbar spine MRI. The archived reports were collectively put in Group 1. A musculoskeletal radiologist and a spine surgeon reviewed the imaging studies together. Their readings were referred to as Group 2. The findings of both groups were compared to evaluate whether disc herniation was overreported. Results Group 1 reported findings of true disc herniation in 112 (41.6%) cases and pseudo disc herniation or no findings of disc herniation at the level of spondylolisthesis in 157 (58.4%) cases. Group 2 reported findings of a true disc herniation in 25 (9.3%) cases and pseudo disc herniation or no findings of disc herniation in the remaining 244 (90.7%) cases. There was a statistically significant difference in the reporting rates between these two groups ( P < 0.02). The most overreported finding was the disc bulging ( P < 0.01). Conclusion The current study showed overreporting of disc herniation in lumbar spine MRI scans performed for patients with established spondylolisthesis. The majority of disc pathology at the level of spondylolisthesis are pseudo disc rather than a true disc herniation. An accurate diagnosis is vital in planning surgical intervention.

scholarly journals Unexpected Findings in Magnetic Resonance Enterography and Their Clinical Significance

2016 ◽  
Vol 2016 ◽  
pp. 1-9
Author(s):  
Srivathsan Ravindran ◽  
Sarah Helen Hancox ◽  
Neil Barlow ◽  
Arthur Dunk ◽  
David Howlett
Keyword(s):  
Magnetic Resonance ◽  
Clinical Significance ◽  
Incidental Findings ◽  
Renal Cysts ◽  
Magnetic Resonance Enterography ◽  
Inflammatory Bowel ◽  
Clinically Significant ◽  
Unexpected Findings ◽  
Abdominal Lymphadenopathy

Aims. To identify the prevalence of colonic and extraenteric incidental findings in magnetic resonance enterography (MRE) and their clinical significance.Methods. We retrospectively analysed 470 MRE studies carried out between March 2012 and 2014. Incidental findings were defined as those not expected from or made apparent on the referral. MRE reports were reviewed for colonic and extraenteric findings, subcategorised into “clinically significant” and “insignificant.” Follow-up was identified from the electronic patient record.Results. The majority of MRE requests were made for inflammatory bowel disease (97%). In total, 114 incidental findings were noted in 94 (20%) scans performed. There were 29 “colonic” findings (25%) with 55% having a diagnosis of colitis. Out of 85 extraenteric findings, ovarian cysts (25%), renal cysts (10%), and abdominal lymphadenopathy (9%) were the commonest. Cumulatively, 59 cases were clinically significant (52%); of these, 30 findings were not previously diagnosed, amounting to 26% of all incidental findings. This led to intervention in seven patients.Conclusions. Incidental findings are common in MRE and there is a substantial proportion that is clinically significant and requires further investigation. There need to be stratification of risk and employment of local guidelines in order to achieve this.

scholarly journals Incidental Extraspinal Findings in the Thoracic Spine during Magnetic Resonance Imaging of Intervertebral Discs

2019 ◽  
Vol 9 ◽  
pp. 37
Author(s):  
Mogahid M. A. Zidan ◽  
Ikhlas A. Hassan ◽  
Abdelrahaman M. Elnour ◽  
Mustafa Z. Mahmoud ◽  
Mohammed A. Alghamdi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Thoracic Spine ◽  
Renal Cysts ◽  
Intervertebral Discs ◽  
Resonance Imaging ◽  
Thyroid Goiter ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri ◽  
Spine Mri

Objective: The purpose of this research was to determine the frequency of incidental extraspinal findings in the thoracic spine on magnetic resonance imaging (MRI). Materials and Methods: A total of 120 thoracic spine MRI patients were prospectively examined in the period extending from August 2018 to April 2019. Both 1.5 and 0.35 Tesla MRI systems (Toshiba and Siemens Medical system) were applied to investigate patients with suspected intervertebral disc abnormalities at three MRI diagnostic centers in Khartoum, Sudan. Results: Out of the 120 patients, incidental extraspinal findings were found in 16 patients (13.3%). Various incidental findings (IFs) were seen, including renal cysts, liver mass, thyroid goiter, and pleural effusion. Out of these IFs, 37.5% were considered clinically significant. Conclusions: Various IFs were identified during a routine thoracic spine MRI, and approximately one-third of them were clinically significant. Therefore, it is essential for the reporting radiologists to pay attention to extraspinal findings while reporting thoracic spine MRI to avoid missing clinically significant findings.

Prevalence and Clinical Significance of Incidental Vertebral Marrow Signal Abnormality in Thoracolumbar Spine MRI

Spine ◽  
2020 ◽  
Vol 45 (6) ◽  
pp. 390-396
Author(s):  
Hans L. Carlson ◽  
Austin R. Thompson ◽  
David R. Pettersson ◽  
Brady Goodwin ◽  
Thomas G. Deloughery ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Thoracolumbar Spine ◽  
Signal Abnormality ◽  
Spine Mri ◽  
Marrow Signal

Analysis of the interventions in antineoplastic therapy by a clinical pharmacy service at a tertiary hospital in Brazil

2021 ◽  
pp. 107815522110176
Author(s):  
Camile da Rocha ◽  
Juliane Carlotto ◽  
Jose Zanis Neto
Keyword(s):  
Monoclonal Antibodies ◽  
Antineoplastic Therapy ◽  
Clinical Significance ◽  
Clinical Pharmacy ◽  
Tertiary Hospital ◽  
Clinical Pharmacy Service ◽  
Drug Related Problems ◽  
Lack Of Information ◽  
Clinically Significant ◽  
Pharmaceutical Interventions

Background Medication errors are avoidable occurrences that can assume clinically significant dimensions and impose relevant costs to the health system, especially in the context of antineoplastic therapy. Objective Assess the clinical significance and economic impacts of a clinical pharmaceutical service. This retrospective study consists of an analysis of pharmacy interventions and drug-related problems found in a review of electronic prescriptions referring to antineoplastic therapy of a public teaching tertiary hospital in Brazil. Method Retrospective descriptive study obtained from electronic records of drug-related problems and pharmaceutical interventions related to antineoplastic therapy for oncological and hematological diseases, obtained through the pharmacotherapy review service. The accepted interventions were analyzed for the financial impact generated, evaluating your direct costs. The perception of clinical significance of a random sample of interventions was ascertained by the experts' opinion, using the Delphi method. Results The most frequent problem was a “lack of information to professionals” (25.06%), “problems as to the frequency and interval of doses” (22.90%), and “medication underdosing” (16.20%). Dose adjustment (31.50%) and clarifications (30.90%) were the most frequent pharmaceutical interventions. In the second round of Delphi, experts rated 77.77% of interventions as extremely significant and very significant. The main drugs reported in the interventions were cyclophosphamide, carboplatin, methotrexate, folinic acid, and monoclonal antibodies. The savings amounted to US$1,193,970.18 and involved mainly bortezomib, dactinomycin, and monoclonal antibodies. Conclusion Clinical pharmacy services contributed to the rational use of medicines presenting clinical significance and avoiding waste of financial resources.

Timeline for Maximal Subjective Outcome Improvement After Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 47 (10) ◽  
pp. 2501-2509 ◽  
Author(s):  
Avinesh Agarwalla ◽  
Richard N. Puzzitiello ◽  
Joseph N. Liu ◽  
Gregory L. Cvetanovich ◽  
Anirudh K. Gowd ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Clinical Significance ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Pubmed Database ◽  
Patient Reported ◽  
Clinically Significant ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are one of the most common traumatic knee injuries experienced by athletes. Return to sport is considered the pinnacle endpoint among patients receiving ACL reconstruction. However, at the time of return to sport, patients may not be participating at their previous levels of function, as defined by clinical metrics. Purpose: To establish when patients perceive maximal subjective medical improvement according to patient-reported outcome measures (PROMs). Study Design: Systematic review. Methods: A systematic review of the PubMed database was conducted to identify studies that reported sequential PROMs up to a minimum of 2 years after ACL reconstruction. Pooled analysis was conducted for PROMs at follow-up points of 3 months, 6 months, 1 year, and 2 years. Clinically significant improvement was determined between pairs of intervals with the minimal clinically important difference. Results: This review contains 30 studies including 2253 patients who underwent ACL reconstruction. Clinically significant improvement in the KOOS (Knee injury and Osteoarthritis Outcome Score) was seen up to 1 year after ACL reconstruction, but no clinical significance was noted from 1 to 2 years. Clinically significant improvement in the IKDC (International Knee Documentation Committee) and Lysholm questionnaires was seen up to 6 months postoperatively, but no clinical significance was noted beyond that. Conclusion: After ACL reconstruction, maximal subjective medical improvement is established 1 year postoperatively, with no further perceived clinical improvement beyond this time point according to current PROMs. The KOOS may be a more responsive metric to subjective improvements in this patient cohort than other patient-reported outcomes, such as the IKDC and Lysholm. Clinical Relevance: After ACL reconstruction, patients perceive interval subjective improvements until 1 year postoperatively.

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