scholarly journals Choose wisely: imaging for diagnosis of axial spondyloarthritis

2021 ◽  
pp. annrheumdis-2021-220136
Author(s):  
Torsten Diekhoff ◽  
Iris Eshed ◽  
Felix Radny ◽  
Katharina Ziegeler ◽  
Fabian Proft ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Axial Spondyloarthritis ◽  
Lower Sensitivity ◽  
Reference Standard ◽  
Sacroiliac Joints ◽  
Cross Sectional ◽  
Rater Reliability ◽  
X Ray ◽  
Cross Sectional Imaging ◽  
Ct And Mri

ObjectiveTo assess the diagnostic accuracy of radiography (X-ray, XR), CT and MRI of the sacroiliac joints for diagnosis of axial spondyloarthritis (axSpA).Methods163 patients (89 with axSpA; 74 with degenerative conditions) underwent XR, CT and MR. Three blinded experts categorised the imaging findings into axSpA, other diseases or normal in five separate reading rounds (XR, CT, MR, XR +MR, CT +MR). The clinical diagnosis served as reference standard. Sensitivity and specificity for axSpA and inter-rater reliability were compared.ResultsXR showed lower sensitivity (66.3%) than MR (82.0%) and CT (76.4%) and also an inferior specificity of 67.6% vs 86.5% (MR) and 97.3% (CT). XR +MR was similar to MR alone (sensitivity 77.5 %/specificity 87.8%) while CT+MR was superior (75.3 %/97.3%). CT had the best inter-rater reliability (kappa=0.875), followed by MR (0.665) and XR (0.517). XR +MR was similar (0.662) and CT+MR (0.732) superior to MR alone.ConclusionsXR had inferior diagnostic accuracy and inter-rater reliability compared with cross-sectional imaging. MR alone was similar in diagnostic performance to XR+MR. CT had the best accuracy, strengthening the importance of structural lesions for the differential diagnosis in axSpA.

scholarly journals 3D imaging of proximal caries in posterior teeth using optical coherence tomography

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yasushi Shimada ◽  
Michael F. Burrow ◽  
Kazuyuki Araki ◽  
Yuan Zhou ◽  
Keiichi Hosaka ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diagnostic Accuracy ◽  
3D Imaging ◽  
Characteristic Curve ◽  
Weighted Kappa ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Posterior Teeth ◽  
Proximal Caries ◽  
X Ray

Abstract Optical coherence tomography (OCT) can create cross-sectional images of tooth without X-ray exposure. This study aimed to investigate the diagnostic accuracy of 3D imaging of OCT for proximal caries in posterior teeth. Thirty-six human molar teeth with 51 proximal surfaces visibly 6 intact, 16 slightly demineralized, and 29 distinct carious changes were mounted to take digital radiographs and 3D OCT images. The sensitivity, specificity and area under the receiver operating characteristic curve (AUC) for the diagnosis of enamel caries and dentin caries were calculated to quantify the diagnostic ability of 3D OCT in comparison with digital radiography. Diagnostic accuracy was evaluated by the agreement with histology using weighted Kappa. OCT showed significantly higher sensitivity, AUC and Kappa values than radiography. OCT can be a safer option for the diagnosis of proximal caries in posterior teeth that can be applied to the patients without X-ray exposure.

scholarly journals Cross-sectional imaging of acute gynaecologic disorders: CT and MRI findings with differential diagnosis—part I: corpus luteum and haemorrhagic ovarian cysts, genital causes of haemoperitoneum and adnexal torsion

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Massimo Tonolini ◽  
Pietro Valerio Foti ◽  
Valeria Costanzo ◽  
Luca Mammino ◽  
Stefano Palmucci ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Corpus Luteum ◽  
Ovarian Cysts ◽  
Adnexal Torsion ◽  
Mri Findings ◽  
Cross Sectional ◽  
Urologic Diseases ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Ct And Mri

AbstractAcute gynaecologic disorders are commonly encountered in daily clinical practice of emergency departments (ED) and predominantly occur in reproductive-age women. Since clinical presentation may be nonspecific and physical findings are often inconclusive, imaging is required for a timely and accurate diagnosis. Although ultrasound is the ideal non-invasive first-line technique, nowadays multidetector computed tomography (CT) is extensively used in the ED, particularly when a non-gynaecologic disorder is suspected and differential diagnosis from gastrointestinal and urologic diseases is needed. As a result, CT often provides the first diagnosis of female genital emergencies. If clinical conditions and scanner availability permit, magnetic resonance imaging (MRI) is superior to CT for further characterisation of gynaecologic abnormalities, due to the excellent soft-tissue contrast, intrinsic multiplanar capabilities and lack of ionising radiation.The purpose of this pictorial review is to provide radiologists with a thorough familiarity with gynaecologic emergencies by illustrating their cross-sectional imaging appearances. The present first section will review the CT and MRI findings of corpus luteum and haemorrhagic ovarian cysts, gynaecologic haemoperitoneum (from either ruptured corpus luteum or ectopic pregnancy) and adnexal torsion, with an emphasis on differential diagnosis. Additionally, comprehensive and time-efficient MRI acquisition protocols are provided.

scholarly journals Cross-sectional imaging of the torso reveals occult injuries in asymptomatic blunt trauma patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Gregory J. Roberts ◽  
Lewis E. Jacobson ◽  
Michelle M. Amaral ◽  
Courtney D. Jensen ◽  
Louis Cooke ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Chest Ct ◽  
Physical Exam ◽  
Trauma Patients ◽  
Cross Sectional ◽  
X Ray ◽  
Cross Sectional Imaging ◽  
Normal Chest ◽  
Chest X Ray ◽  
Sectional Imaging

Abstract Background High morbidity and mortality rates of trauma injuries make early detection and correct diagnosis crucial for increasing patient’s survival and quality of life after an injury. Improvements in technology have facilitated the rapid detection of injuries, especially with the use of computed tomography (CT). However, the increased use of CT imaging is not universally advocated for. Some advocate for the use of selective CT imaging, especially in cases where the severity of the injury is low. The purpose of this study is to review the CT indications, findings, and complications in patients with low Injury Severity Scores (ISS) to determine the utility of torso CT in this patient cohort. Methods A retrospective review of non-intubated, adult blunt trauma patients with an initial GCS of 14 or 15 evaluated in an ACS verified level 1 trauma center from July 2012 to June 2015 was performed. Data was obtained from the hospital’s trauma registry and chart review, with the following data included: age, sex, injury type, ISS, physical exam findings, all injuries recorded, injuries detected by torso CT, missed injuries, and complications. The statistical tests conducted in the analysis of the collected data were chi-squared, Fischer exact test, and ANOVA analysis. Results There were 2306 patients included in this study, with a mean ISS of 8. For patients with a normal chest exam that had a chest CT, 15% were found to have an occult chest injury. In patients with a negative chest exam and negative chest X-ray, 35% had occult injuries detected on chest CT. For patients with a negative abdominal exam and CT abdomen and pelvis, 16% were found to have an occult injury on CT. Lastly, 25% of patients with normal chest, abdomen, and pelvis exams with chest, abdomen, and pelvis CT scans demonstrated occult injuries. Asymptomatic patients with a negative CT had a length of stay 1 day less than patients without a corresponding CT. No incidents of contrast-induced complications were recorded. Conclusions A negative physical exam combined with a normal chest X-ray does not rule out the presence of occult injuries and the need for torso imaging. In blunt trauma patients with normal sensorium, physical exam and chest X-ray, the practice of obtaining cross-sectional imaging appears beneficial by increasing the accuracy of total injury burden and decreasing the length of stay.

scholarly journals Retroperitoneal lymphangiectasia: a great clinical masquerade

2020 ◽  
Vol 8 (2) ◽  
pp. 748
Author(s):  
Siddhant Uttam Manwar ◽  
Manisha Vishnu Joshi ◽  
Devdas Sudhakar Shetty ◽  
Upendra Diwakar Bhalerao
Keyword(s):  
Clinical Presentation ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Colour Doppler ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Anatomical Extent ◽  
Sectional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Ct And Mri

Retroperitoneal lymphangiectasia is a very rare lymphatic disorder characterized by abnormal proliferation of lymphatics. We present series of 3 cases of retroperitoneal lymphangiectasia which are diagnosed in our institute with the help of Ultrasonography (USG), Computed Tomography (CT) and Magnetic resonance imaging (MRI) of abdomen and pelvis with unusual clinical presentation. We include clinical features and imaging findings of this disorder with its pathogenesis and diagnosis. Two of the cases were clinically masquerading as hernia and one case was mimicking varicocele. Thorough clinical examination and USG, colour Doppler, CT and MRI are extremely helpful imaging investigation that aid in differentiating these lesions from hernia/ varicocele and the cross sectional imaging like CT and MRI can  depict the anatomical extent of the disease.

scholarly journals Ultrasound to Detect Central Venous Catheter Placement Associated Complications

2020 ◽  
Vol 132 (4) ◽  
pp. 781-794 ◽  
Author(s):  
Jasper M. Smit ◽  
Mark E. Haaksma ◽  
Endry H. T. Lim ◽  
Thei S. Steenvoorden ◽  
Michiel J. Blans ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Diagnostic Accuracy ◽  
Central Venous Catheterization ◽  
Venous Catheter ◽  
Reference Standard ◽  
Central Venous ◽  
Central Venous Catheter Placement ◽  
X Ray ◽  
Venous Catheterization ◽  
Chest X Ray

Abstract Background Mechanical complications arising after central venous catheter placement are mostly malposition or pneumothorax. To date, to confirm correct position and detect pneumothorax, chest x-ray film has been the reference standard, while ultrasound might be an accurate alternative. The aim of this study was to evaluate diagnostic accuracy of ultrasound to detect central venous catheter malposition and pneumothorax. Methods This was a prospective, multicenter, diagnostic accuracy study conducted at the intensive care unit and postanesthesia care unit. Adult patients who underwent central venous catheterization of the internal jugular vein or subclavian vein were included. Index test consisted of venous, cardiac, and lung ultrasound. Standard reference test was chest x-ray film. Primary outcome was diagnostic accuracy of ultrasound to detect malposition and pneumothorax; for malposition, sensitivity, specificity, and other accuracy parameters were estimated. For pneumothorax, because chest x-ray film is an inaccurate reference standard to diagnose it, agreement and Cohen’s κ-coefficient were determined. Secondary outcomes were accuracy of ultrasound to detect clinically relevant complications and feasibility of ultrasound. Results In total, 758 central venous catheterizations were included. Malposition occurred in 23 (3.3%) out of 688 cases included in the analysis. Ultrasound sensitivity was 0.70 (95% CI, 0.49 to 0.86) and specificity 0.99 (95% CI, 0.98 to 1.00). Pneumothorax occurred in 5 (0.7%) to 11 (1.5%) out of 756 cases according to chest x-ray film and ultrasound, respectively. In 748 out of 756 cases (98.9%), there was agreement between ultrasound and chest x-ray film with a Cohen’s κ-coefficient of 0.50 (95% CI, 0.19 to 0.80). Conclusions This multicenter study shows that the complication rate of central venous catheterization is low and that ultrasound produces a moderate sensitivity and high specificity to detect malposition. There is moderate agreement with chest x-ray film for pneumothorax. In conclusion, ultrasound is an accurate diagnostic modality to detect malposition and pneumothorax. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Imaging in axial spondyloarthritis

2016 ◽  
Author(s):  
Stefan Siebert ◽  
Sengupta Raj ◽  
Alexander Tsoukas
Keyword(s):  
New York ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Imaging Modalities ◽  
X Rays ◽  
Mri Imaging ◽  
Sacroiliac Joints ◽  
X Ray ◽  
X Ray Imaging ◽  
Imaging Results

Imaging has always been a key component in the diagnosis of ankylosing spondylitis as part of the modified New York criteria. With the increased availability of MRI and the development of the ASAS axial spondyloarthritis (axSpA) criteria, there has been a shift from x-ray imaging of structural damage to MRI imaging of inflammation. This information can help in both the diagnosis of axSpA and in guiding treatment decisions in patients with this diagnosis. However, imaging results must be evaluated in the context of the clinical picture and should not be acted on in isolation. Here we review the key imaging modalities used in axSpA, with the main focus on x-rays and MRI of the sacroiliac joints, spine, and peripheral structures. Advances in technology are also likely to lead to the development of even better imaging modalities for axSpA in future.

Direct cross-sectional imaging using X-ray Compton scattering: application to commercial batteries

2021 ◽  
Vol 28 (4) ◽  
Author(s):  
Naruki Tsuji ◽  
Kentaro Kajiwara ◽  
Masayoshi Itou ◽  
Yoshiharu Sakurai
Keyword(s):  
Compton Scattering ◽  
Three Dimensional ◽  
Regions Of Interest ◽  
Cross Sectional ◽  
X Ray ◽  
Dimensional Image ◽  
Sample Rotation ◽  
Direct Cross ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

A synchrotron-based technique using Compton scattering imaging is presented. This technique has been applied to a coin battery (CR2023), and the cross-sectional image has been obtained in 34 ms without sample rotation. A three-dimensional image of the whole structure has been reconstructed from 74 cross-sectional images taken consecutively by scanning the incident, wide X-ray beam along one direction. This work demonstrates that quick cross-sectional imaging of regions of interest and three-dimensional image reconstruction without sample rotation are feasible using Compton scattering imaging.

Image Distortion Compensation by Using a Polynomial Model in an X-Ray Digital Tomosynthesis System

2005 ◽  
Vol 297-300 ◽  
pp. 2034-2039 ◽  
Author(s):  
J.Y. Kim ◽  
J.S. Yoon
Keyword(s):  
Flip Chip ◽  
Image Intensifier ◽  
Industrial Applications ◽  
Image Distortion ◽  
Polynomial Model ◽  
Digital Tomosynthesis ◽  
Cross Sectional ◽  
Distortion Compensation ◽  
X Ray ◽  
Cross Sectional Imaging

X-ray technology has been widely used in a number of industrial applications for monitoring and inspecting inner defects which can hardly be found by normal vision systems as a ball grid array (BGA) or a flip chip array (FCA). Digital tomosynthesis (DT) is one of the most useful X-ray cross-sectional imaging methods for PCB inspection, and it usually uses an X-ray image intensifier. However, the image intensifier distorts X-ray images severely both of shape and intensity. This distortion breaks the correspondences between those images and prevents us from acquiring accurate cross-section images. Therefore, image distortion compensation is one of the most important issues in realizing a DT system. In this paper, an image distortion compensation method for an X-ray DT system is presented. It is to use a general distortion polynomial model on two dimensional plane that can cope with arbitrary, complex and various forms of distortion. Experimental results show a great improvement in compensation speed and accuracy.

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