Contrast enhancement on 100- and 120 kVp hepatic CT scans at thin adults in a retrospective cohort study

Abstract Introduction Isolated nasal obstruction (INO) is a common complaint of multiple etiology. The preoperative evaluation of patients presenting with nasal obstruction and deviated nasal septum (DNS) does not typically include imaging. The benefits of performing computed tomography (CT) in the preoperative setting are inconclusive. Objective Assessing the contribution of preoperative CT to the surgical treatment of non-sinusitis patients presenting with INO and DNS. Methods A retrospective cohort study on patients referred to surgery for nasal obstruction due to DNS or turbinate hypertrophy between 2006 and 2015. Data was retrieved from patients' medical charts. The CT scans and clinical data were reassessed by a second surgeon blinded to the patients' clinical course. Results Seventy of the 843 patients (8.06%) who underwent endoscopic sinonasal procedures during the study period had presented with INO and met the inclusion criteria. Thirty-eight (55.88%) of them underwent CT scans during their preoperative assessment. Modification of the initial preoperative planning based on the radiological findings was required in 32 cases (84.2%). When reassessed by a second blinded surgeon, 58% of cases required surgical modification rather than classical submucosal resection of nasal septum and turbinate reduction (P = 0.048). Conclusion Computed tomography was found beneficial in the preoperative planning for patients with INO. The original surgical plan based upon physical examination findings was modified based on radiological findings in 84.2% of the patients.

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Faculty Opinions recommendation of Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717297801.793352818 ◽

2012 ◽

Author(s):

Rosalia Misseri

Keyword(s):

Cohort Study ◽

Radiation Exposure ◽

Retrospective Cohort Study ◽

Brain Tumours ◽

Retrospective Cohort ◽

Ct Scans ◽

Subsequent Risk

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Prevalence of Maxillary Sinus Hypoplasia and Silent Sinus Syndrome: A Radiological Cross-Sectional Retrospective Cohort Study

American Journal of Rhinology and Allergy ◽

10.1177/19458924211029418 ◽

2021 ◽

pp. 194589242110294

Author(s):

Umberto D’Agostino Fiorenza ◽

Chiara Spoldi ◽

Liudmila Nekrasova ◽

Carlotta Pipolo ◽

Paolo Lozza ◽

...

Keyword(s):

Cohort Study ◽

Maxillary Sinus ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Septal Deviation ◽

Ct Scans ◽

Concha Bullosa ◽

Cross Sectional ◽

Silent Sinus Syndrome ◽

Maxillary Sinus Hypoplasia

Background Maxillary sinus hypoplasia (MSH), associated with enophthalmos and hypoglobus in the silent sinus syndrome (SSS), is a poorly studied condition. The real incidence of MSH and SSS in the adult population is not known. Our study aims at estimating the radiological prevalence of MSH and identifying undiagnosed cases of SSS in a retrospective cohort. Methods A cross-sectional retrospective cohort study was performed in adults, without a history of maxillofacial surgery or trauma, undergoing head CT scans. A radiological database of 1012 consecutive scans was reviewed independently by two authors to identify patients with signs of MSH and SSS and associated findings (septal deviation, uncinate deviation, concha bullosa, sinus opacification, bony rarefaction, and pterygopalatine fossa enlargement). The findings of MSH and SSS were compared with radiological reports. Results 891 eligible CT scans were analyzed. MSH and SSS prevalences were 6.17% (n = 55) and 0,56% (n = 5), respectively. The maxillary sinus was normally or partially ventilated in 96.36% of MSH patients. Lateralization of the uncinate process was detected in about 50% of MSH patients, while a septal deviation towards the affected sinus was detected in 21.82%. In 20% of MSH scans, a concha bullosa was identified. Radiological reports identified a single MSH case. Conclusions Our study confirmed the literature data on MSH prevalence, while it determined a precedently unknown prevalence for SSS, underestimated in the radiology reports. This prevalence needs further confirmation but suggests a routine accurate comparison of both maxillary sinuses in CT scans.

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LO69: A retrospective cohort study on the impact of point-of-care ultrasound on radiologic imaging in patients presenting to the emergency department with suspected uncomplicated renal colic

CJEM ◽

10.1017/cem.2019.112 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S32-S33

Author(s):

J. Alain ◽

R. Huard ◽

A. Mokhtari ◽

M. Parent ◽

D. Simonyan ◽

...

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Renal Colic ◽

Point Of Care ◽

Ct Scans ◽

Point Of Care Ultrasound ◽

Kappa Score ◽

Radiologic Imaging

Introduction: The number of CT scans prescribed in the Emergency department (ED) for suspected renal colic has increased over recent years without an associated improvement in patient-centred outcomes. We assessed whether Point-of-Care Ultrasound (PoCUS) decreases the use of formal radiologic imaging. Methods: We completed a retrospective cohort study on consecutive patients 18 years of age and older presenting to the ED with suspected uncomplicated renal colic in a tertiary care centre in Québec in 2016. Exclusion criteria included: previous urologic intervention, solitary kidney, dialysis, fever, pyuria, acute kidney injury, pregnancy, suspicion of a serious alternative diagnosis or persistent symptoms despite analgesia. We compared the proportion (95%CI) of formal radiologic imaging performed (Ultrasound or CT) in patients who had PoCUS in the ED vs. those who did not. Two-tailed Fisher exact test (α = 0.05) and odds ratios (95%CI) calculated from multivariate logistic regression models adjusted for age, gender, Charlson Index and previous renal colic were used to compare the two groups. The reliability of data collection was evaluated with a kappa score (95%CI). Results: 169 patients with uncomplicated renal colic were included. There was no difference between the groups in terms of age, gender, Charlson Index, or previous renal colic. The PoCUS level of training and the doctor's education level was significantly higher in the PoCUS group. There was a non-significant trend towards less formal imaging in patients of the PoCUS group 65/88 (73.9% [63.4-82.7%]) vs. the non-PoCUS group 69/81 (85.2% [75.6-92.1%]), p = 0.087. After adjustment for confounders, the patients not evaluated with PoCUS were more likely to have formal imaging with a significant odds ratio of 2.41 [1.05-5.56]). Among patients who underwent a CT, incidentalomas were found in 16.5% and only 2.0% demonstrated significant findings leading to changes in ED management, such as an alternative diagnosis, need for admission, or an urgent urological intervention. Inter-observer agreement was excellent between assessers with a kappa score of 0.88 [0.66-1.00]. Conclusion: ED patients with uncomplicated renal colic who are investigated with PoCUS tend to have fewer formal imaging test. When CT scans were performed, incidentalomas were found in 16.5% and ED management changed only 2.0% of the time. PoCUS appears to be a useful tool for decreasing CT utilisation in this low-risk ED population.

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