scholarly journals Diagnostic Accuracy of Contrast-Enhanced FLAIR Magnetic Resonance Imaging in Diagnosis of Meningitis Correlated with CSF Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Aneel Kumar Vaswani ◽  
Waseem Mehmood Nizamani ◽  
Muhammad Ali ◽  
Geeta Aneel ◽  
Bhesham Kumar Shahani ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Signs And Symptoms ◽  
Leptomeningeal Carcinomatosis ◽  
Radiology Department ◽  
Mri Findings ◽  
Mri Brain ◽  
Flair Sequence ◽  
Csf Analysis ◽  
Contrast Enhanced ◽  
A Prospective Study

Purpose. To determine the diagnostic accuracy of contrast enhanced FLAIR sequence of MRI brain in the diagnosis of meningitis. Subjects and Methods. A prospective study of 57 patients with signs and symptoms of meningitis, referred to the radiology department for MRI examination. Out of these, there were 30 males and 27 females. They underwent MRI brain with contrast including postcontrast T1W and FLAIR sequences. Cerebrospinal fluid (CSF) analysis obtained by lumbar puncture after MRI was considered the “reference standard” against which MRI findings were compared. Results. Of 57 patients, 50 were diagnosed as having meningitis on subsequent CSF analysis. Out of these 50, 49 were positive on postcontrast FLAIR images and 34 were positive on postcontrast T1W images. One patient was labeled false positive as CSF analysis showed malignant cells (leptomeningeal carcinomatosis). In the diagnosis of meningitis, the sensitivity of postcontrast FLAIR sequence was 96% and specificity 85.71%, whereas the sensitivity of postcontrast T1W sequence was 68% and specificity 85.71%. Conclusion. Contrast-enhanced FLAIR sequence is more sensitive and specific than contrast-enhanced T1W sequence in the diagnosis of meningitis. It should be routinely used in suspected cases of meningitis.

scholarly journals The value of contrast-enhanced FLAIR magnetic resonance imaging in detecting meningeal abnormalities in suspected cases of meningitis compared to conventional contrast-enhanced T1WI sequences

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Wael Hamza Kamr ◽  
Mohamed Gaber Eissawy ◽  
Amr Saadawy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Early Diagnosis ◽  
Diagnosis And Treatment ◽  
Effective Management ◽  
Resonance Imaging ◽  
Flair Sequence ◽  
Csf Analysis ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri

Abstract Background Early diagnosis of meningitis with magnetic resonance imaging (MRI) would be useful for appropriate and effective management, decrease morbidity and mortality, and provide better diagnosis and treatment. The objective of the current study is to compare the accuracy of contrast-enhanced FLAIR (CE-FLAIR) and contrast-enhanced T1WI (CE-T1WI) in the detection of meningeal abnormalities in suspected cases of meningitis. Results Out of 45 patients, 37 patients were confirmed to have meningitis on CSF analysis. Out of the 37 patients, 34 patients were positive on CE-FLAIR sequence and 27 were positive on CE-T1WI. The sensitivity of CE-FLAIR sequence was 91.9% and specificity 100%, while the sensitivity of CE-T1WI sequence was 73% and specificity 100%. Conclusion CE-FLAIR is more sensitive than CE-T1WI in diagnosis of meningitis. It is recommended to be used in any cases with clinically suspected meningitis.

scholarly journals Limited role of DWI with apparent diffusion coefficient mapping in breast lesions presenting as non-mass enhancement on dynamic contrast-enhanced MRI

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Daly Avendano ◽  
Maria Adele Marino ◽  
Doris Leithner ◽  
Sunitha Thakur ◽  
Blanca Bernard-Davila ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Curves ◽  
Breast Cancer Diagnosis ◽  
Breast Lesions ◽  
Mri Findings ◽  
Adc Value ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Mass Enhancement

Abstract Background Available data proving the value of DWI for breast cancer diagnosis is mainly for enhancing masses; DWI may be less sensitive and specific in non-mass enhancement (NME) lesions. The objective of this study was to assess the diagnostic accuracy of DWI using different ROI measurement approaches and ADC metrics in breast lesions presenting as NME lesions on dynamic contrast-enhanced (DCE) MRI. Methods In this retrospective study, 95 patients who underwent multiparametric MRI with DCE and DWI from September 2007 to July 2013 and who were diagnosed with a suspicious NME (BI-RADS 4/5) were included. Twenty-nine patients were excluded for lesion non-visibility on DWI (n = 24: 12 benign and 12 malignant) and poor DWI quality (n = 5: 1 benign and 4 malignant). Two readers independently assessed DWI and DCE-MRI findings in two separate randomized readings using different ADC metrics and ROI approaches. NME lesions were classified as either benign (> 1.3 × 10−3 mm2/s) or malignant (≤ 1.3 × 10−3 mm2/s). Histopathology was the standard of reference. ROC curves were plotted, and AUCs were determined. Concordance correlation coefficient (CCC) was measured. Results There were 39 malignant (59%) and 27 benign (41%) lesions in 66 (65 women, 1 man) patients (mean age, 51.8 years). The mean ADC value of the darkest part of the tumor (Dptu) achieved the highest diagnostic accuracy, with AUCs of up to 0.71. Inter-reader agreement was highest with Dptu ADC max (CCC 0.42) and lowest with the point tumor (Ptu) ADC min (CCC = − 0.01). Intra-reader agreement was highest with Wtu ADC mean (CCC = 0.44 for reader 1, 0.41 for reader 2), but this was not associated with the highest diagnostic accuracy. Conclusions Diagnostic accuracy of DWI with ADC mapping is limited in NME lesions. Thirty-one percent of lesions presenting as NME on DCE-MRI could not be evaluated with DWI, and therefore, DCE-MRI remains indispensable. Best results were achieved using Dptu 2D ROI measurement and ADC mean.

scholarly journals Comparison of ultrasound and Contrast- enhanced computed tomography in clinically diagnosed cases of acute pancreatitis

2021 ◽  
Vol 8 (1) ◽  
pp. 51-57
Author(s):  
Pooja Jaiswal ◽  
Shreejana Shrestha ◽  
Yogita Dwa
Keyword(s):  
Acute Pancreatitis ◽  
Diagnostic Accuracy ◽  
Standard Technique ◽  
Dynamic Imaging ◽  
Radiology Department ◽  
Imaging Features ◽  
Imaging Findings ◽  
Imaging Characteristics ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced

Introduction: Acute pancreatitis (AP) is an acute, mainly diffuse, inflammatory process of the pancreas with dynamic imaging characteristics and a multitude of possible complications. Imaging plays an important role in the diagnosis of AP. As most of the AP cases are gallstone-related, ultrasound (USG) is the most common initial radiologic investigation of choice. Contrast-enhanced CT (CECT) is the standard technique for overall assessment of AP and its complications. This study aims to compare diagnostic accuracy of imaging findings of USG with CECT. Method: This was a retrospective review of imaging findings of USG and CECT in clinically diagnosed cases of AP who visited Radiology Department of Patan Hospital, Patan Academy of Health Sciences, Kathmandu, Nepal during 2015 to 2019 and had undergone USG and CECT. The diagnostic accuracy of USG and CECT imaging findings were compared. Study was approved ethically. Result: Among 210 clinically diagnosed cases of acute pancreatitis, USG accurately diagnosed 97(46.2%), CECT 180(85.7%). Both the modalities detected cholelithiasis in 17% of the cases. Out of 97 cases, 85 showed focal or diffuse enlargement of pancreas on USG. Conclusion: The CECT showed higher diagnostic accuracy for acute pancreatitis as compared to ultrasound, 85.7% vs. 46.2%. The overall visualization of the imaging features of AP and its complications was better by CECT than by USG.

scholarly journals Cerebrospinal Fluid Analysis Predicts Enhancement on MRI in Bacterial and Tuberculous Meningitis: A Retrospective Observational Study

2021 ◽  
Author(s):  
Ryoji Goto ◽  
Yurino Horiuchi ◽  
Haruka Kawakami ◽  
Ayaka Chikada ◽  
Tsutomu Yasuda ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Tuberculous Meningitis ◽  
Mri Findings ◽  
Fluid Analysis ◽  
Csf Analysis ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Discriminant Ability ◽  
Mri Scans ◽  
Contrast Enhanced Mri

Abstract Background Along with cerebrospinal fluid (CSF) analysis, enhancement on contrast-enhanced MRI scans are useful to diagnose and presume the pathogen of meningitis. However, the conditions for its appearance have not been clarified. This study aimed to investigate the possibility of CSF parameters as predictors of the existence of enhancement on contrast-enhanced head or spinal MRI scans in patients with bacterial meningitis (BM) or tuberculous meningitis (TM).Methods A total of 12 patients with BM and 23 patients with TM who underwent both CSF analyses and contrast-enhanced MRI scans were included in this study. The correlation between CSF analyses and MRI findings has been examined using receiver operating characteristic (ROC) analysis.Results Contrast enhancement was found in 7 and 10 patients with BM and TM, respectively. In patients with BM, higher CSF protein and lower CSF glucose were associated with the presence of the enhancement on MRI, while the CSF leukocyte or neutrocyte count did not show any difference. In contrast, not only the CSF protein and glucose but also the leukocyte and lymphocyte counts were associated with the enhancement in patients with TM. Furthermore, CSF adenosine deaminase (ADA) in patients with TM showed neither correlation with CSF leukocyte count nor discriminant ability of the MRI findings.Conclusions CSF analysis predicts the existence of enhancement on contrast-enhanced MRI scans of the central nervous system both in patients with BM and those with TM. Our findings about the CSF cell count and CSF ADA indicate the mechanism of the blood–brain barrier (BBB) breakdown in BM and TM.

scholarly journals MRI Assessment of Paediatric Developmental Delay

2021 ◽  
Vol 10 (8) ◽  
pp. 479-483
Author(s):  
Konika Chaudhary ◽  
Shivali Vaibhav Kashikar ◽  
Rajasbala Pradeep Dhande
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Developmental Delay ◽  
High Yield ◽  
Radiology Department ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Structural Morphology ◽  
Mri Brain ◽  
Study Results

BACKGROUND Developmental delay is defined as a significant delay in the infant's developmental domains. Magnetic resonance imaging (MRI) is the best diagnostic tool to investigate such cases. Evaluation of a child with developmental delay is essential because it allows for early diagnosis and treatment and helps in counselling the parents regarding the outcome and to identify any possible risk of recurrence. METHODS The present study was conducted in AVBR Hospital, Sawangi, Wardha. This crosssectional descriptive study was conducted for magnetic resonance imaging assessment of brain in patients with developmental delay aged three months to 15 years. Males and females were both included in our study. The paediatrics department referred all patients with developmental delay or delayed milestones to the radiology department, where they underwent MRI brain with gadolinium contrast (Brivo MR 355 1.5 Tesla). A total of 104 patients was included in the present study. RESULTS In our present study, distribution of the MRI findings based on structural morphology was 49 (47.12 %), 43 (41.35 %), 30 (28.85 %), 11 (10.58 %), 8 (7.69 %), and 3 (2.88 %) patients with abnormal findings in ventricles, corpus callosum, white matter, grey matter, cerebellum, brainstem respectively. Use of contrast was significant only in 4 (3.85 %) patients. Use of contrast was ineffective in 100 (96.15 %) patients, and the difference was statistically significant (P < 0.001), stating that the use of contrast is ineffective in such patients. CONCLUSIONS MRI evaluation of the brain contributes to the diagnosis of aetiologies of developmental delay. Clinical diagnosis of the developmental delay should not be the only endpoint. MRI is the best investigation with a high yield in such developmental delay patients. KEY WORDS Developmental Delay, MRI Brain, Paediatric Patients

scholarly journals MRI Evaluation of Seizures in Pediatric Age Group Patients in a Rural Hospital of Central India

2021 ◽  
pp. 167-172
Author(s):  
Nishant Raj ◽  
Rajasbala Pradeep Dhande
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Central India ◽  
Febrile Seizures ◽  
Rural Hospital ◽  
Radiology Department ◽  
Mri Findings ◽  
Pediatric Age Group ◽  
Magnetic Resonance Imaging Mri ◽  
A Prospective Study

Background: Seizures are a common presenting complaint in pediatric patients. There are many underlying causes which may present as seizures in pediatric population, for example: febrile seizures, hypoxic ischemic encephalopathy, congenital malformations, certain neoplasms etc. Magnetic resonance imaging(MRI) plays a fundamental role in evaluation of these causes and is especially of use in identifying the structural lesions presenting as seizures. Objectives: To assess the role of MRI(1.5 Tesla) in evaluation pediatric seizures and to study spectrum of MRI findings associated with various causes. Methodology: A prospective study will be conducted at “Acharya Vinoba Bhave Rural Hospital, Sawangi”, involving 138 pediatric patients coming to Radiology department. Results: After statistical analysis, we expect to find effectiveness of MRI in evaluation of pediatric seizures. Conclusion: In this study we expect to find usefulness of MRI as a diagnostic tool in assessment of pediatric seizures especially in those with structural lesions.

scholarly journals Accuracy of ultrasound in detection of Hepatocellular Carcinoma in cirrhotic patients.

2020 ◽  
Vol 27 (01) ◽  
pp. 185-190
Author(s):  
Bushra Riaz ◽  
Rakhshanda Jabbar ◽  
Owais Bin Qadeer ◽  
Nasira Parveen ◽  
Fouzia Sultan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Abdominal Cavity ◽  
Tertiary Care ◽  
False Negative ◽  
Radiology Department ◽  
True Negative ◽  
Contrast Enhanced ◽  
Cirrhotic Patients

Objectives: Evaluate the accuracy of ultrasonography in the diagnosis of hepatocellular carcinoma among cirrhotic patients by comparing it with contrast enhanced multiphasic MRI. Study Design: Cross sectional study. Setting: Radiology Department through OPD\Admitted\emergency, Allied Hospital, Faisalabad. Period: 01-01-2018 to 30-06-2018. Material & Methods: A total of 91 cases, having symptoms of fatigue, weakness, vomiting, nausea, loss of appetite, abdominal pain, weight loss and bloating when the fluid is accumulated in abdominal cavity, itching, spider-like blood vessels on the skin were included in the study. Informed written consent was taken from all the patients or their next of kin after explaining the procedure, objectives and benefits of study. All the patients were examined with Conventional gray scale ultrasound using curvilinear probe of 5MHz and then with 1.5 tesla MR imager. Results: The diagnostic accuracy was computed as 42.86%(n=39) as true positive, 1.10%(n=1) as false positive, 49.45%(n=45) false negative and 6.59%(n=6) had true negative, while 46.43%(sensitivity), 85.71%(specificity), 97.5%(positive predictive value), 88.24%(negative predictive value), and 49.45%(diagnostic accuracy) were calculated. Conclusion: We concluded that the accuracy of ultrasonography for the diagnosis of hepatocellular carcinoma among cirrhotic patients by comparing it with contrast enhanced multiphasic MRI is in agreement with the previous studies, though its accuracy rate is lower but specificity is significantly higher and recommended in our country in low resource settings and tertiary care setups where diagnostic facilities are limited functional.

scholarly journals Feasibility and Efficacy of Lung Ultrasound to Diagnose Postoperative Hypoxemia-A Prospective Study

2020 ◽  
Author(s):  
Chen Xie ◽  
Kai Sun ◽  
Yueyang You ◽  
Yue Ming ◽  
Xiaoling Yu ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
General Anesthesia ◽  
Lung Ultrasound ◽  
Pulmonary Complications ◽  
Radiology Department ◽  
Postoperative Hypoxemia ◽  
Thoracic Computed Tomography ◽  
A Prospective Study

Abstract Background Postoperative hypoxemia is associated with morbidity and mortality. We aim to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose pulmonary complications in patients suffering from hypoxemia after general anesthesia, and compare to thoracic computed tomography (CT).Methods Adult patients received general anesthesia and suffered from hypoxemia in the PACU, were analyzed. Hypoxemia was defined as a SPO2 less than 92% for greater than 30 seconds on room air. LUS was performed by a trained anesthesiologist once hypoxemia occurred. After LUS examination, each patient was transported to radiology department for thoracic CT scan within 1 hour before returning to the ward.Results From January 2019 to May 2019, 113 patients (61 men) undergoing abdominal surgery (45 patients, 39.8%), video-assisted thoracic surgery (31 patients, 27.4%), major orthopedics surgery (17 patients, 15.0%), neurosurgery (10 patients, 8.8%) and other surgery (10 patients, 8.8%) were included. CT diagnosed 327 of 1356 lung zones as atelectasis while LUS revealed atelectasis in 311 of the CT-confirmed zones. Pneumothorax was detected by CT scan in 75 quadrants, 72 of which were detected by LUS. Pleural effusion was diagnosed in 144 zones on CT scan and LUS detected 131 of these zones. LUS was reliable in diagnosing atelectasis (sensitivity 98.0%, specificity 96.7% and diagnostic accuracy 97.2%), pneumothorax (sensitivity 90.0%, specificity 98.9% and diagnostic accuracy 96.7%) and pleural effusion (sensitivity 92.9%, specificity 96.0% and diagnostic accuracy 95.1%).Conclusions Lung ultrasound is feasible, efficient and accurate in diagnosing different etiologies of postoperative hypoxia in the PACU.

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