scholarly journals Diagnostic Performance of Plain Film, Ultrasonography, and Computed Tomography in Nasal Bone Fractures: A Systematic Review

2018 ◽  
Vol 26 (4) ◽  
pp. 286-292 ◽  
Author(s):  
Kun Hwang ◽  
Joon Soo Jung ◽  
Hun Kim
Keyword(s):  
Computed Tomography ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Plain Film ◽  
Lateral View ◽  
Performance Accuracy ◽  
Significant Difference ◽  
Sensitivity Specificity

Purpose: The aim of this study was to compare the diagnostic performance (accuracy, sensitivity, specificity, positive predictive value, and negative predictive value) of plain film (PF), ultrasonography (USG), and computed tomography (CT) in diagnosing nasal bone fractures (NBFs). Methods: In a search of PubMed and Scopus, “nasal bone fracture” AND “X-ray OR CT OR USG OR MRI” were searched. Among the 369 titles from PubMed and 379 titles from Scopus, 257 duplicate titles were excluded and 491 titles were reviewed. Among them, 36 full articles were reviewed. From these, 21 were excluded and 1 mined article was added; thus, 16 articles were reviewed. Results: The accuracy of CT (94.4% ± 2.3%) was significantly higher ( P < .001) than that of USG (85.0% ± 3.6%). The accuracy of USG was significantly higher ( P < .001) than that of PF (67.7% ± 4.7%). Computed tomography (89.3% ± 3.1%) and USG (87.2% ± 3.3%) were significantly more sensitive than PF ( P < .001 and P < .001, respectively). The specificity of CT (94.2% ± 2.3%) was significantly higher ( P = .001) than that of USG (87.4% ± 3.3%). The specificity of USG was significantly higher ( P < .001) than that of PF (67.8% ± 4.7%). Among the PF techniques, combining a lateral view and the Water’s view (71.8% ± 4.5%) had significantly higher accuracy than a lateral view alone (62.4% ± 4.8%) or the Water’s view alone (61.0% ± 4.9%). In USG, there was no significant difference ( P = .300) in accuracy among lateral and dorsal views (95.8% ± 2.0%), a lateral view alone (84.2% ± 3.7%), and a dorsal view alone (84.2% ± 3.6%). Conclusion: The results of this review might be helpful in choosing the most appropriate diagnostic tool in patients suspected having NBF.

scholarly journals Spiral Flow Fube for Contrast Medium Reduction in Coronary CT Angiography

2017 ◽  
Vol 9 ◽  
Author(s):  
Nobuo Tomizawa ◽  
Yayoi Hayakawa ◽  
Shinichi Inoh ◽  
Takeshi Nojo ◽  
Satoshi Uemura ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Left Main ◽  
Spiral Flow ◽  
Flow Tube ◽  
Coronary Ct ◽  
Shaped Tube ◽  
Significant Difference ◽  
Sensitivity Specificity

<p align="left"><strong>Objectives</strong></p><p align="left">To assess the diagnostic performance and enhancement of coronary CT with reduced contrast medium using the spiral flow tube compared with the T-shaped tube.</p><p align="left"><strong>Methods</strong></p><p align="left">We retrospectively included 444 patients who underwent catheter examination within 2 months after coronary CT. The first 222 patients received 21.0 mgI/kg/s of contrast medium using the T-shaped tube and the injected contrast medium was reduced by 6% (19.8 mgI/kg/s) in the last 222 patients using the spiral flow tube. We compared the per vessel diagnostic performance for detecting obstructive stenosis (≥50%) by catheter examination and the enhancement of proximal coronary arteries.</p><p align="left"><strong>Results</strong></p><p align="left">The sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 96%, 84%, 72%, 98% and 87% using the spiral flow tube and 93%, 83%, 68%, 97% and 86% using the T-shaped tube, respectively, without significance. The enhancement of left main (spiral flow vs T-shape, 407 ± 53 vs 407 ± 62 HU, <em>p</em> = 0.95) and right coronary (419 ± 58 vs 415 ± 61 HU, <em>p</em> = 0.49) arteries did not show significant difference.</p><p align="left"><strong>Conclusions</strong></p><p align="left">The spiral flow tube would maintain the diagnostic performance and coronary enhancement with reduced contrast medium compared with the T-shaped tube.</p>

scholarly journals Musculoskeletal injuries in a resource-constrained environment: comparing diagnostic accuracy of on-the-spot ultrasonography and conventional radiography for bone fracture screening during the Paris–Dakar rally raid

2015 ◽  
Vol 4 (5) ◽  
pp. 205846011557756 ◽  
Author(s):  
Benjamin Dallaudière ◽  
Ahmed Larbi ◽  
Mathieu Lefere ◽  
Anne Perozziello ◽  
Olivier Hauger ◽  
...  
Keyword(s):  
Predictive Value ◽  
Bone Fractures ◽  
High Sensitivity ◽  
Conventional Radiography ◽  
Styloid Process ◽  
Resource Constrained ◽  
X Ray ◽  
Men 2 ◽  
Significant Difference ◽  
Sensitivity Specificity

Background Ultrasound (US) is a good first-line alternative for the diagnosis of bone fractures in adults as well as children. Our study shows that, compared to X-ray, in a resource-constrained environment, on-site US has a high sensitivity (98%) and specificity (96%) in the diagnosis of bone fractures. Purpose To compare the accuracy of on-the-spot US with conventional radiography in the screening for bone fractures during the Paris–Dakar rally raid. Material and Methods Eighty-three patients (81 men, 2 women) with clinically suspected bone fractures were included in 2013 and 2014. They underwent X-ray and US on the spot, blindly interpreted by two musculoskeletal radiologists. Using X-ray as gold standard, we calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US, for each anatomic location. The accuracy of US and radiography were also assessed, as were the number of fragments and their degree of displacement (Student’s t-test). Results Compared with X-ray, sensitivity, specificity, PPV, and NPV of on-site US were, respectively, for the presence (or absence) of fractures: 98%, 98%, 100%, and 95%. The accuracy of US was 99%. Only one radial styloid process fracture was misdiagnosed with US. There was no significant difference between US and X-ray ( P > 0.93) concerning the number of fragments and their degree of displacement. Conclusion Bedside musculoskeletal ultrasound performed by trained musculoskeletal radiologists is a useful method in determining and assessing bone fractures in a resource constrained environment.

Noninvasive Evaluation of Coronary Artery Bypass Grafts with 16-Slice Multidetector Computed Tomography

2012 ◽  
Vol 15 (1) ◽  
pp. 12 ◽  
Author(s):  
Levent Sahiner ◽  
Ali Oto ◽  
Kudret Aytemir ◽  
Tuncay Hazirolan ◽  
Musturay Karcaaltincaba ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Multidetector Computed Tomography ◽  
Coronary Artery Bypass ◽  
Predictive Value ◽  
Artery Bypass ◽  
Time Interval ◽  
Mdct Angiography ◽  
Sensitivity Specificity

<p><b>Background:</b> The aim of this study was to investigate the diagnostic accuracy of 16-slice multislice, multidetector computed tomography (MDCT) angiography for the evaluation of grafts in patients with coronary artery bypass grafting (CABG).</p><p><b>Methods:</b> Fifty-eight consecutive patients with CABG who underwent both MDCT and conventional invasive coronary angiography were included. The median time interval between the 2 procedures was 10 days (range, 1-32 days). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT for the detection of occluded grafts were calculated. The accuracy of MDCT angiography for detecting significant stenoses in patent grafts and the evaluability of proximal and distal anastomoses were also investigated.</p><p><b>Results:</b> Optimal diagnostic images could not be obtained for only 3 (2%) of 153 grafts. Evaluation of the remaining 150 grafts revealed values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the MDCT angiography procedure for the diagnosis of occluded grafts of 87%, 97%, 94%, 93%, and 92%, respectively. All of the proximal anastomoses were optimally visualized. In 4 (8%) of 50 patent arterial grafts, however, the distal anastomotic region could not be evaluated because of motion and surgical-clip artifacts. The accuracy of MDCT angiography for the detection of significant stenotic lesions was relatively low (the sensitivity, specificity, PPV, and NPV were 67%, 98%, 50%, and 99%, respectively). The number of significant lesions was insufficient to reach a reliable conclusion, however.</p><p><b>Conclusion:</b> Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.</p>

scholarly journals Predictive Evaluation on Cytological Sample of Metastatic Melanoma: The Role of BRAF Immunocytochemistry in the Molecular Era

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1110
Author(s):  
Andrea Ronchi ◽  
Marco Montella ◽  
Federica Zito Marino ◽  
Michele Caraglia ◽  
Anna Grimaldi ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Molecular Analysis ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Braf V600e ◽  
Mutational Status ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Background: Cutaneous malignant melanoma is an aggressive neoplasm. In advanced cases, the therapeutic choice depends on the mutational status of BRAF. Fine needle aspiration cytology (FNA) is often applied to the management of patients affected by melanoma, mainly for the diagnosis of metastases. The evaluation of BRAF mutational status by sequencing technique on cytological samples may be inconvenient, as it is a time and biomaterial-consuming technique. Recently, BRAF immunocytochemistry (ICC) was applied for the evaluation of BRAF V600E mutational status. Although it may be useful mainly in cytological samples, data about BRAF ICC on cytological samples are missing. Methods: We performed BRAF ICC on a series of 50 FNA samples of metastatic melanoma. BRAF molecular analysis was performed on the same cytological samples or on the corresponding histological samples. Molecular analysis was considered the gold standard. Results: BRAF ICC results were adequate in 49 out of 50 (98%) cases, positive in 15 out of 50 (30%) cases and negative in 34 out of 50 (68%) of cases. Overall, BRAF ICC sensitivity, specificity, positive predictive value and negative predictive value results were 88.2%, 100%, 100% and 94.1%, respectively. The diagnostic performance of BRAF ICC results was perfect when molecular evaluation was performed on the same cytological samples. Hyperpigmentation represents the main limitation of the technique. Conclusions: BRAF ICC is a rapid, cost-effective method for detecting BRAF V600E mutation in melanoma metastases, applicable with high diagnostic performance to cytological samples. It could represent the first step to evaluate BRAF mutational status in cytological samples, mainly in poorly cellular cases.

scholarly journals Value of preoperative computed tomography for meso-Rex bypass in children with extrahepatic portal vein obstruction

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Huiying Wu ◽  
Ning Zhou ◽  
Lianwei Lu ◽  
Xiwen Chen ◽  
Tao Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Portal Vein ◽  
Predictive Value ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction ◽  
Left Portal Vein ◽  
History Of ◽  
Associated Malformations ◽  
Sensitivity Specificity

Abstract Background Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO. Results We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively. Conclusions Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.

scholarly journals Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

2014 ◽  
Vol 47 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Vilson Lacerda Brasileiro Junior ◽  
Aníbal Henrique Barbosa Luna ◽  
Marcelo Augusto Oliveira de Sales ◽  
Tânia Lemos Coelho Rodrigues ◽  
Priscilla Lopes da Fonseca Abrantes Sarmento ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Carotid Arteries ◽  
Panoramic Radiography ◽  
Digital Panoramic Radiography ◽  
Significant Difference ◽  
Mcnemar’S Test ◽  
Sensitivity Specificity

Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcifications were accuracy, sensitivity, specificity and positive predictive value of this method as compared with ultrasonography. Additionally, the McNemar's test was utilized to verify whether there was a statistically significant difference between digital panoramic radiography and ultrasonography. Results Ultrasonography demonstrated carotid artery calcifications in 17 (48.57%) patients. Such individuals presented with a total of 29 (41.43%) carotid arteries affected by calcification. Radiography was accurate in 71.43% (n = 50) of cases evaluated. The degree of sensitivity of this method was 37.93%, specificity of 95.12% and positive predictive value of 84.61%. A statistically significant difference (p < 0.001) was observed between the methods evaluated in their capacity to diagnose carotid artery calcifications. Conclusion Digital panoramic radiography should not be indicated as a method of choice in the investigation of carotid artery calcifications.

Diagnostic Performance and Reliability of the Standardized Computed Tomography Reporting System for Acute Appendicitis: Experience in a Tertiary Care Academic Center

2021 ◽  
Vol 104 (7) ◽  
pp. 1102-1108
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Interobserver Agreement ◽  
Reporting System ◽  
Lower Quadrant ◽  
Suspected Appendicitis ◽  
Diagnostic Certainty

Background: Computed tomography (CT) is generally accepted as a modality of choice for imaging workup in patients with suspected appendicitis. A standardized CT reporting system, CT certainty score, has been proposed to improve diagnostic accuracy and to reduce ambiguous CT reports. Objective: To assess the diagnostic performance and the reliability of the standardized CT reporting system for acute appendicitis in Thai adults. Materials and Methods: The present study was a retrospective data review of 421 adult patients who had CT scans of the appendix between January 2016 and December 2017. The clinical and imaging data were extracted and analyzed. The pathological result was used as a standard of reference. The diagnostic performance and interobserver agreement of the standardized CT reporting system were estimated. Results: One hundred sixty-three patients, with a mean age of 41.7 years, had clinical diagnoses of acute appendicitis. Using standardized CT report, radiologists were highly accurate at diagnosing appendicitis [area under curve (AUC) 0.988 (95% CI 0.98 to 1.00); p<0.001]. The estimated sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.1% (95% CI 90.6 to 97.9), 95.7% (95% CI 92.5 to 97.9), 93.4% (95% CI 88.7 to 96.2), 96.9% (95% CI 93.0 to 97.2), 95.5% (95% CI 93.0 to 97.3), respectively. The interobserver agreement was greater than 80% for all binary objective findings and more than 90% agreement on the presence or absence of greater-than-3-mm wall thickness, appendicolith, periappendiceal air, and right lower quadrant fluid collection. The use of CT certainty score had interobserver agreement of 78% (κ=0.69; 95% CI 0.62 to 0.77). Conclusion: Using a standardized CT reporting system yielded a high diagnostic accuracy and high reproducibility of supportive CT findings for appendicitis in at-risk patients. The standardized CT reporting system can improve diagnostic certainty, accuracy, and guide patient management. Keywords: Appendicitis; Certainty score; Computed tomography; Standardized reporting system

35. Accuracy of anal cytology in predicting histological HSIL: baseline results from the Australian Study of the Prevention of Anal Cancer (SPANC)

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 587
Author(s):  
Jennifer Roberts ◽  
Clare Biro ◽  
Annabelle Farnsworth ◽  
Debbie Ekman ◽  
Marjorie Adams ◽  
...  
Keyword(s):  
Predictive Value ◽  
Screening Program ◽  
Anal Carcinoma ◽  
Hiv Positive ◽  
Homosexual Men ◽  
Significant Difference ◽  
Anal Cytology ◽  
Cytological Abnormality ◽  
Sensitivity Specificity ◽  
The Bethesda System

Background Anal cytology may form the basis of a future screening program to prevent anal carcinoma. Therefore, the accuracy of anal Papanicolaou tests in detecting histological HSIL needs to be evaluated. Methods: SPANC is a 3-year prospective study in homosexual men aged ≥35 years. At each of five visits, men undergo collection of a ThinPrep® anal cytological sample, high-resolution anoscopy (HRA) and biopsy of any abnormalities. Cytology is reported using the Bethesda system. Histology is reported using lower anogenital squamous terminology. Results: 351 men had a baseline visit by end July 2013. Median age was 49 (range: 35–79) years and 101 (28.8%) men were HIV positive. Anal cytology results were: unsatisfactory in 21 (6.0%), negative in 143 (40.7%), ASC-US in 51 (14.5%), LSIL in 22 (6.3%), ASC-H in 45 (12.8%) and HSIL in 69 (19.7%). 293 of 351 (83.5%) men had baseline histology. The most severe abnormality for each was: negative for SIL in 98 (33.4%), LSIL in 87 (29.7%) and HSIL in 108 (36.9%). Anal cytology sensitivity for histological HSIL (at ASC-US threshold) was 79.0%. Specificity was 53.8%. Positive predictive value (PPV) of any cytological abnormality for histological HSIL was 44.4% and PPV of HSIL cytoprediction was 63.8%. Negative predictive value (NPV) was 84.6%. Overall there was no significant difference between HIV positive and negative men with respect to sensitivity, specificity, PPV or NPV. Conclusions: These results indicate that histological HSIL is common in homosexual men. The finding of any cytological abnormality should prompt HRA. However, both cytology and HRA can miss or underestimate significant lesions in a single screening.

320-multidetector cardiac computed tomography in the evaluation of conotruncal anomalies

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Elnagar ◽  
U Ghieda ◽  
A Ibrahim ◽  
M Dawoud
Keyword(s):  
Computed Tomography ◽  
Effective Dose ◽  
Predictive Value ◽  
Cardiac Computed Tomography ◽  
Preoperative Evaluation ◽  
Mdct Angiography ◽  
Complex Anatomy ◽  
Conotruncal Anomalies ◽  
The Mean ◽  
Sensitivity Specificity

Abstract Background Multi-detector computed tomography (MDCT) has become an effective tool in the assessment of congenital heart disease in infants and children. Purpose To evaluate the role of 320-row MDCT in the assessment of conotruncal anomalies and compare it with echocardiography (echo) considering the operative and/or catheter findings as the gold standard. Methods The studied group included 50 patients having conotruncal anomalies. All patients were evaluated with 320-row MDCT angiography. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of MDCT and echo were calculated. The patient effective dose was reported. Results The overall sensitivity, specificity, accuracy, PPV and NPV for MDCT angiography in assessment of various abnormalities in patients with conotruncal anomalies were 98.97%, 100%, 99.75%, 100% and 99.67% for MDCT angiography. Sensitivity, specificity, PPV and NPV of MDCT angiography were 97.87%, 100%, 100% and 99.04% and 99.49%, 100%, 100% &99.86% for the detection of intracardiac defects and extracardiac vascular anomalies respectively. The mean absorbed radiation dose was 63.63 mGy-Cm per scan and the mean effective dose was 1.56±0.47 mSv. Conclusion 320-MDCT angiography offers an excellent diagnostic procedure in the preoperative evaluation of the complex anatomy of the conotruncal anomalies. Funding Acknowledgement Type of funding source: None

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