scholarly journals MRI versus Ultrasonography in detection of suspected placental invasion

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R H Abdallah ◽  
L A Habib ◽  
Y A Abdallah ◽  
M S Seweed ◽  
N M Youssry

Abstract Purpose of this study is to highlight the role of MRI and U/S in suspected placental invasion. Methods 40 patients were included in our study. All clinically suspected patients with previous CS or surgical intervention were subjected to US and MRI. Results Our study demonstrated that MRI has a significant promising tool factor for detection of placental invasion degree with high sensitivity, specificity and accuracy and superior to ultrasound in detection of degree of invasion. Conclusion MRI imaging of the placenta is of high sensitivity the diagnosis of degree of invasion better than US which couldn’t accurately detect the depth of invasion. Another advantage of MRI is that it’s not operator dependent and gives better tissue characterization.

Author(s):  
Sevitha Bhat ◽  
Kavya Ramamurthy ◽  
Shalini Shenoy ◽  
Aseem Rangnekar

ABSTRACTObjectives: Mycobacterium tuberculosis (MTB) remains one of the most significant causes of mortality and morbidity in developing countriesespecially India. India has the highest burden of TB, with an estimated incidence figure of 2.1 million cases out of the 9 million cases of TB globally.Diagnosis of TB relies on conventional microscopy and culture with drawbacks related to sensitivity, specificity, turn around time (TAT). The aim ofthis study was to evaluate the performance of Xpert MTB/rifampicin (RIF) assay (GX) for MTB detection in pulmonary and extrapulmonary clinicalsamples.Methods: A total of 209 clinical specimens (182: pulmonary and 27: extrapulmonary) were processed using auramine smear, culture by mycobacteriagrowth indicator tube and GenXpert.Results: The sensitivity of GenXpert was 62.63% for pulmonary and 55% for extrapulmonary samples. The sensitivity and specificity of GX were100% for the smear positive cases. The sensitivity, specificity, positive predictive value, and negative predictive value of the GX for smear negativecases were 67.8%, 97.5%, 90.4%, and 89.6%, respectively. RIF resistance was detected in 3.8% the samples.Conclusion: GenXpert, with short TAT, high sensitivity, specificity and less technical expertise required is a promising tool in TB diagnostics for thefuture.Keywords: GenXpert, Tuberculosis diagnosis, Molecular method, Rifampicin resistance.


2008 ◽  
Vol 15 (01) ◽  
pp. 26-32
Author(s):  
TAHIR MALIK ◽  
ZAFAR AMIN ◽  
TAHIR MALIK

) To determine the role of ultrasonography as the primaryimaging modality in patients of acute abdomen. (2) To evaluate the sensitivity, specificity, positive and negativepredictive value of ultrasonography in acute abdomen. Design: A hospital based descriptive study. Setting: InCombined Military Hospital Lahore which is a tertiary care hospital. Period: From 1 Jan 2003 to 30 Dec 2003. stSubjects: A total of 100 consecutive patients of acute abdomen were selected for the study. There were 61 malepatients and 39 female patients. The patients’ age ranged from 02 years to 70 years. Ultrasonography was done usingALOKA SSD-5500 machine with high resolution probes. Results: During my study of patients of acute abdomen mostcommon conditions encountered were renal colic due to renal and ureteric stones followed by gut perforation,cholecystitis, appendicitis and cholelithiasis. My study revealed a sensitivity of 79.7% and specificity of 88.4% ofultrasonography in patients with acute abdomen. The positive predictive value was 95.1% and a negative predictivevalue was 60.5%. Conclusion: Ultrasonography helped in prompt decision making in most of the cases of acuteabdomen with a high sensitivity and specificity in skilled and experienced hands, as well as high positive predictivevalue. Hence, in our setup it can be used as a primary imaging modality for patients presenting with acute abdomenin any age group, as it is readily available, cost effective and free of any radiation hazards. Ultrasonography not onlyhelps in diagnosing the cause of pain but also ruling out other possibilities.


2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 384-384
Author(s):  
Hussein Mustafa Khaled ◽  
Abdel-Rahman Zekri ◽  
Mai B Mohamed ◽  
Fatma M Diab ◽  
Mona Abdellateif ◽  
...  

384 Background: Microsatellite alterations in urine sediments have proved to be a promising tool for detection of bladder cancer (BC) due to its high sensitivity and specificity. Methods: We assessed the possible prognostic and predictive values of microsatellite alterations in tissue samples and urine sediments obtained from Egyptian patients with BC, and their utility as diagnostic, prognostic and predictive value. Microsatellite instability (MSI) and loss of heterozygosity (LOH) were assessed using 13 microsatellite markers in tumor tissue and urine sediments of 30 patients with BC. The concordance between MSI in tissue and urine samples was determined. Results: We found that MSI was more frequent than LOH (100% and 46.7%; respectively). D16S310, MBP and IFN-α showed the highest MSI frequency in urine samples (70%, 70% and 66.67%; respectively), while MBP, ACTBP2 and D9S171 (66.67%, 63.33%, and 60%; respectively) were the most frequently detected in tumor tissue. All markers correlated significantly with the pathological subtypes (more frequent in TCC) and hematuria. The concordance between tissue and urine was statistically significant for , D9S171, D16S476, FGA and ACTBP2 (P = 0.04, 0.015, 0.02 and 0.007; respectively). When we combined D16S476 and D9S171, the sensitivity, specificity, PPV and NPV reached (80.0%, 75.0%, 82.8% and 71.4%; respectively) for diagnosis of BC . Conclusions: Thus MSI in urine sediments could be a sensitive and reliable method for diagnosis of BC.


2021 ◽  
Vol 56 (2) ◽  
pp. 110-115
Author(s):  
Jonathan Roth ◽  
Tali Jonas Kimchi ◽  
Ben Shofty ◽  
Ariel Agur ◽  
Liat Ben-Sira ◽  
...  

Background: Mechanical shunt malfunction may lead to significant morbidity and mortality. Shunt series assessments help evaluate shunt integrity; however, they are of limited value in the area of the skull due to skull curvature, thickness, and air sinuses. We describe the role of 3D bone reconstruction CT (3DCT) in demonstrating the shunt integrity over the skull, comparing this technique to skull X-rays (SXR). Methods: Data were collected retrospectively for shunted patients with concurrent SXR and 3DCT and for patients presenting with shunt failures at the region of the skull, including clinical course and radiological findings. We compared the SXR and 3DCT findings. The 3DCT was reconstructed from standard diagnostic CT protocols performed during evaluation of suspected shunt malfunction and not thin-slice CT protocols. Results: Forty-eight patients with 57 shunts underwent SXR and 3DCT. Interobserver agreement was high for most variables. Both SXR and 3DCT had a high sensitivity, specificity, and accuracy identifying tubing disconnections (between 0.83 and 1). Full valve type and setting were significantly more accurate based on SXR versus 3DCT (>90 vs. <20%), and valve integrity was significantly more readily verified on 3DCT versus SXR (100 vs. 52%). Conclusions: 3DCT and SXR complement each other in diagnosing mechanical shunt malfunctions over the skull. The main limitation of 3DCT is identification of valve type and settings, which are clearer on SXR, while the main limitation of SXR is a less ability to evaluate valve integrity. 3DCT also enables an intuitive 3D understanding of the shunt tubing over the skull.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S286-S286
Author(s):  
Monprach Harnphadungkit ◽  
Taweegrit Siripongboonsitti

Abstract Background The coronavirus disease 2019 (COVID-19) has a wide range of severity. Chest computed tomography (CT) had high sensitivity and specificity to identify COVID-19 pneumonia. However, chest CT was not available in almost all hospitals in pandemic settings, including developed countries. This study is to evaluate the potential role of conventional inflammatory biomarkers to predict COVID-19 pneumonia. Methods All 155 RT-PCR-confirmed COVID-19 patients were evaluated for pneumonia by chest CT from April 10, 2021 to May 3, 2021 in the outpatient unit, a Thai university hospital. The inflammatory biomarkers were evaluated the sensitivity, specificity, LR+, LR-, and ROC to predict COVID-19 pneumonia. Results Of all 155 patients, pneumonia was diagnosed by chest CT in 117 patients. The pneumonia patients had a median (IQR) age of 38 (30, 55) years old. The BMI was higher in pneumonia than mild illness in 25.5 (22.0, 29.5) and 22.9 (19.4, 26.9) kg/m2, respectively (p=0.031). In univariate analysis, serum high-sensitivity C-reactive protein (hsCRP), lactate dehydrogenase (LDH), ferritin, total lymphocyte count (TLC), and albumin were associated with pneumonia, but the only hsCRP demonstrated association by multivariate analysis. The area under the ROC curves (AUC) was 0.82, 0.74, 0.68, 0.38, and 0.37 in hsCRP, LDH, ferritin, TLC, and albumin, respectively. The optimal cut-off level for CRP to diagnose COVID-19 pneumonia was 2.00 mg/L given sensitivity, specificity, LR+, LR- of 81.9%, 70.3%, 2.75, and 0.26 respectively (Figure 1 and Table 1). ROC Curve of hsCRP to Diagnose of COVID-19 Pneumonia This figure shows ROC curve for hsCRP to diagnose of chest CT-confirmed COVID-19 pneumonia. The area under the ROC curve is 0.82. The optimal cut-off value for hsCRP is 2.00 given sensitivity of 81.9% and specificity of 70.3%. Conclusion The hsCRP was the conventional biomarker that had an excellent performance in predicting COVID-19 pneumonia lead to early anti-SARS-CoV-2 treatment. This study demonstrated the potential role of hsCRP combined with clinical assessment in negative chest X-rays to replace chest CT in a high burden COVID-19 country during pandemic situations. Disclosures All Authors: No reported disclosures


PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242840
Author(s):  
Samia Boussouar ◽  
Mathilde Wagner ◽  
Victoria Donciu ◽  
Nicoletta Pasi ◽  
Joe Elie Salem ◽  
...  

Objective To evaluate the diagnostic performance of the initial chest CT to diagnose COVID-19 related pneumonia in a French population of patients with respiratory symptoms according to the time from the onset of country-wide confinement to better understand what could be the role of the chest CT in the different phases of the epidemic. Material and method Initial chest CT of 1064 patients with respiratory symptoms suspect of COVID-19 referred between March 18th, and May 12th 2020, were read according to a standardized procedure. The results of chest CTs were compared to the results of the RT-PCR. Results 546 (51%) patients were found to be positive for SARS-CoV2 at RT-PCR. The highest rate of positive RT-PCR was during the second week of confinement reaching 71.9%. After six weeks of confinement, the positive RT-PCR rate dropped significantly to 10.5% (p<0.001) and even 2.2% during the two last weeks. Overall, CT revealed patterns suggestive of COVID-19 in 603 patients (57%), whereas an alternative diagnosis was found in 246 patients (23%). CT was considered normal in 215 patients (20%) and inconclusive in 1 patient. The overall sensitivity of CT was 88%, specificity 76%, PPV 79%, and NPV 85%. At week-2, the same figures were 89%, 69%, 88% and 71% respectively and 60%, 84%, 30% and 95% respectively at week-6. At the end of confinement when the rate of positive PCR became extremely low the sensitivity, specificity, PPV and NPV of CT were 50%, 82%, 6% and 99% respectively. Conclusion At the peak of the epidemic, chest CT had sufficiently high sensitivity and PPV to serve as a first-line positive diagnostic tool but at the end of the epidemic wave CT is more useful to exclude COVID-19 pneumonia.


2020 ◽  
Vol 22 (3) ◽  
pp. 305
Author(s):  
Huaiyu Wu ◽  
Hongtian Tian ◽  
Fajin Dong ◽  
Weiyu Liang ◽  
Di Song ◽  
...  

Aims: In this systematic review and meta-analysis, we discuss the value of grey-scale ultrasonography (US) in diagnosing adhesive capsulitis of the shoulder (ACS).Material and methods: We retrieved relevant studies from PubMed, Cochrane Library, and Embase before 8 April 2019. We selected 7 studies concerning 446 patients (490 shoulders) that used grey-scale US to diagnose ACS and magnetic resonance imaging (MRI) or arthroscopy as the reference standard. We assessed the diagnostic accuracy of US on the basis of combined sensitivity, specificity, likelihood ratio (LR), and the area under the summary receiver operating characteristic (SROC) curve (AUC).Results: The combined sensitivity, specificity, positive LR and negative LR were found to be 88% (95%CI: 74–95), 96% (95%CI: 88–99), 23.89 (95%CI: 6.31–90.51) and 0.12 (95%CI: 0.05–0.29), respectively. The AUC was 0.97 (95%CI: 0.96–0.98). ACS was diagnosed on the basis of four US features: coracohumeral ligament thickening, inferior capsule/axillary recess capsule thickening, rotator interval abnormality, and restriction of the range of motion. The corresponding sensitivities were 64.4 (95%CI: 48.8–78.1), 82.1 (95%CI: 73.8–88.7), 82.6 (95%CI: 74.1–89.2) and 94.3 (95%CI: 84.3–98.8), respectively, and specificities were 88.9 (95%CI: 76.0–96.3), 95.7 (95%CI: 90.3–98.6), 93.9 (95%CI: 89.8–96.7), and 90.9 (95%CI: 75.7–98.1), respectively.Conclusions: Our meta-analysis showed that grey-scale US plays a significant role in the diagnosis of ACS. Because of its high sensitivity and specificity, US can be added to the existing clinical diagnosis program.


Author(s):  
Mohammadali Jiwani ◽  
Pankaj Banode ◽  
Ashutosh Kharche ◽  
Atieya Jiwani ◽  
S Vaidhya

AbstractJaundice is a common problem in society, it is important to discriminate between obstructive and non obstructive cause due to high morbidity in cases of obstructive jaundice, also non obstructive jaundice requires medical management while obstructive jaundice requires surgical intervention. Our study was done with aims to determine role of MRCP in cases of obstructive jaundice in correlation with ultrasonography keeping post surgical follow ups/ ERCP/ histopathology as gold standard for final diagnosis. All patients in our study undergone USG followed by MRCP. We had included total 100 patients out of which 58 females and 42 males. Out of all patients we have observed 56 malignant causes and 44 benign causes. We have observed benign conditions are seen more frequently in adults while increase in frequency of malignancy with increase in age thus there found to have direct relationship of malignant etiology with increase in age. Most common benign cause observed in our study was choledocholithiasis while most common malignancy was carcinoma head of pancreas. In our study we have concluded that MRCP is better modality with high sensitivity, specificity and diagnostic accuracy as compared to USG also with use of MRCP invasive procedures like ERCP can be avoided just for diagnostic purpose. We have also noticed few limitations of both USG and MRCP in process of diagnosis.


2020 ◽  
Vol 51 (3) ◽  
pp. 795-806 ◽  
Author(s):  
Elizabeth J. Short ◽  
Rachael Cooper Schindler ◽  
Rita Obeid ◽  
Maia M. Noeder ◽  
Laura E. Hlavaty ◽  
...  

Purpose Play is a critical aspect of children's development, and researchers have long argued that symbolic deficits in play may be diagnostic of developmental disabilities. This study examined whether deficits in play emerge as a function of developmental disabilities and whether our perceptions of play are colored by differences in language and behavioral presentations. Method Ninety-three children participated in this study (typically developing [TD]; n = 23, developmental language disorders [DLD]; n = 24, attention-deficit/hyperactivity disorder [ADHD]; n = 26, and autism spectrum disorder [ASD]; n = 20). Children were videotaped engaging in free-play. Children's symbolic play (imagination, organization, elaboration, and comfort) was scored under conditions of both audible language and no audible language to assess diagnostic group differences in play and whether audible language impacted raters' perception of play. Results Significant differences in play were evident across diagnostic groups. The presence of language did not alter play ratings for the TD group, but differences were found among the other diagnostic groups. When language was audible, children with DLD and ASD (but not ADHD) were scored poorly on play compared to their TD peers. When language was not audible, children with DLD were perceived to play better than when language was audible. Conversely, children with ADHD showed organizational deficits when language was not available to support their play. Finally, children with ASD demonstrated poor play performance regardless of whether language was audible or not. Conclusions Language affects our understanding of play skills in some young children. Parents, researchers, and clinicians must be careful not to underestimate or overestimate play based on language presentation. Differential skills in language have the potential to unduly influence our perceptions of play for children with developmental disabilities.


Author(s):  
Suraj Mathur

This prospective study was done in the Department of Radio diagnosis Govt. Medical College, Kozhikode. A total of 65 patients who were referred to our department with clinical suspicion of endometrial lesions and incidentally detected endometrial lesions on ultrasonography underwent transvaginal ultrasound and subsequent Imaging evaluation of pelvis MRI has very high sensitivity (95%) and specificity (98%) and is almost as accurate (97%) as histopathology in differentiating benign from malignant lesions. Addition of DWI with ADC mapping to conventional MRI increases its accuracy even more. However there is inherent limitation to MRI in detecting carcinoma in situ and micrometastasis. Keywords: TVS, MRI, Sensitivity, Specificity, Histopathology.


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