Thoax CT Scan as Invasive Fungal Infection (IFI) Screening In Neutropenic Patients, a Prospective-Retrospective Experience of It Impact on Therapeutic Intervention.

Abstract Abstract 4554 Introduction: Persistent fever in high risk neutropenic patients (HRNF) after day 5 of empiric treatment is a sign of high susceptibility for IFI with elevated morbidity and mortality. Diagnostic tools in this setting are inaccurate to determine the occurrence of IFI and most patients start with empiric antifungal agents. Drugs are usually associated with increasing costs and toxicity. It is challenging to establish the population of patients in whom in spite of persistent fever and neutropenia, avoidance of antifungal treatment is a reasonable strategy. Methods: We have prospectively allocated 229 HRNF patients in different empiric antimicrobial regimens over a 4.5 year period. In a retrospective revision, there were 33 patients with persistent fever on day 5 of empirical antimicrobial treatment and no evident new infection episode or clinical impairment. In 28 patients, a thorax CT scan was performed as part of the evaluation of persistent fever. The clinical outcome was evaluated regarding the presence or absence of pulmonary infiltrates in the CT scans. Initial empiric antifungal treatment, transfusions, days in hospital, days with neutropenia, antimicrobial treatment, and days with fever were evaluated. Results: Nineteen patients (68%) of 28 presented with pulmonary infiltrates. All of them received antifungal treatment. In 9 patients with normal CT scan antifungal treatment was deferred. The difference of the decision in not giving antifungals according CT scans was highly significant (p <0,0001). Transfusions of red blood cells and platelets were significantly less in the group of normal scans (p 0,0004 and 0,005 respectively). Antimicrobial treatment, days in hospital and days with fever were not significantly different in both groups. There was one death in the normal scan group due to relapse. Mortality was not significantly different in both groups. Conclusion: In HRNP, normal thorax CT scan changed the clinical decision in not starting antifungal treatment in spite of persistent fever. There was no difference in mortality with patients under antifungal treatment, allowing continuing with this strategy in more patients in the future. Disclosures: No relevant conflicts of interest to declare.

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Dynamic monitor of CT scan within short interval in invasive pulmonary aspergillosis for nonneutropenic patients: a retrospective analysis in two centers

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01512-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fei Chen ◽

Yonghong Zhong ◽

Na Li ◽

Huijie Wang ◽

Yanbin Tan ◽

...

Keyword(s):

Ct Scan ◽

Respiratory Diseases ◽

Short Interval ◽

Invasive Pulmonary Aspergillosis ◽

Host Factors ◽

Antifungal Treatment ◽

Ct Scans ◽

Pulmonary Aspergillosis ◽

European Organization ◽

Life Threatening

Abstract Background In nonneutropenic patients with underlying respiratory diseases (URD), invasive pulmonary aspergillosis (IPA) is a life-threatening disease. Yet establishing early diagnosis in those patients remains quite a challenge. Methods A retrospective series of nonneutropenic patients with probable or proven IPA were reviewed from January 2014 to May 2018 in Department of Respiratory Medicine of two Chinese hospitals. Those patients were suspected of IPA and underwent lung computed tomography (CT) scans twice within 5–21 days. The items required for IPA diagnosis were assessed by their host factors, mycological findings and CT scans according to the European Organization for Research and Treatment of Cancer (EORTC) and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) criteria (EORTC/MSG criteria). Results Together with the risk factors, mycological findings and nonspecific radiological signs on first CT, ten patients were suspected of IPA. With the appearance of cavities on second CT scan in the following days, all patients met the criteria of probable or possible IPA. Except one patient who refused antifungal treatment, nine patients received timely antifungal treatment and recovered well. One of the nine treated IPA cases was further confirmed by pathology, one was confirmed by biopsy. Conclusions Dynamic monitor of CT scan provided specific image evidences for IPA diagnosis. This novel finding might provide a noninvasive and efficient strategy in IPA diagnosis with URD.

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Safety and Efficacy of Caspofungin as Preventive and Empirical Antifungal Treatment of Neutropenic Allografted Patients.

Blood ◽

10.1182/blood.v104.11.5024.5024 ◽

2004 ◽

Vol 104 (11) ◽

pp. 5024-5024

Author(s):

Patrice Chevallier ◽

Pierre Bordigoni ◽

Thierry Lamy ◽

Philippe Moreau ◽

Jean-Luc Harousseau ◽

...

Keyword(s):

Amphotericin B ◽

Antifungal Therapy ◽

Antibacterial Therapy ◽

Conditioning Regimen ◽

Antifungal Treatment ◽

High Dose ◽

Myeloablative Conditioning ◽

Who Grade ◽

Persistent Fever ◽

Neutropenic Patients

Abstract Antifungal therapy is appropriate in neutropenic patients who have unexplained persistent fever, despite receipt of few days of antibacterial therapy. Conventional or liposomal amphotericin B are the preferred agents in this situation for allografted patients but toxicity or interaction with other drugs could limit their prescription. Caspofungin, the first inhibitor of fungal cell wall glucan synthesis, is the only echinocandin approved by the FDA for treatment of candidiasis. In case of suspected or documented aspergillosis infection, caspofungin is generally reserved to patients who failed to respond to amphotericin B or voriconazole. Recently, Walsh et al (ICAAC 2003) demonstrated in a randomised trial that caspofungin was comparable to liposomal amphotericine B in overall success as empirical antifungal therapy of persistently febrile neutropenic patients and was better tolerated. Here, we report our experience of caspofungin as preventive and empirical anti-fungal treatment, between November 2002 and May 2003, in 19 allografted patients with neutropenia (< 500/mm3 neutrophils) ± persistent fever despite at least 4 days of appropriate antibacterial therapy (n=12). There were 15 adult and 4 children, 11 male and 8 female. Median age was 33 years (range: 3–57). There were 6 ALL, 5 AML, 1 Myelodysplasia, 1 CML, 1 Hodgkin disease, 1 NHL, 1 myeloma, 1 aplastic anemia, 1 carcinoma and 1 Ewing sarcoma. A myeloablative conditioning regimen was used in 14 patients consisting of total body irradiation (TBI) plus high-dose chemotherapy in 9 patients and busulfan plus cyclophosphamide in 5 patients. A non myeloablative conditioning regimen was used in 5 patients. For graft-versus-host disease prophylaxis, the regimen was cyclosporin plus methotrexate in 13 patients or ATG in 6 patients. Nine patients received a bone marrow graft, 9 received granulocyte-colony-stimulating factor (G-CSF) mobilized peripheral blood stem-cells and 1 received an unrelated cord blood transplant. Twelve/19 patients have received prophylaxis with fluconazole from day 0 of the graft. Patients received caspofungin at an initial dose of 70 mg then 50 mg per day. Caspofungin was initiated within a median of 10 days after allograft (range: 0–174) including 7 patients receiving preventive caspofungin treatment at the date of aplasia. The mean duration of caspofungin therapy was 16 days (range: 3–72). Caspofungin was well tolerated and not stopped because of toxicity: WHO grade 1 and 2 hepatotoxicity occurred in 5 patients including 3 with previous hepatic abnormalities, WHO grade 1 and 2 nephrotoxicity occurred in 6 patients. No infusion reaction was observed. Only one patient developed a probable invasive bronchopulmonary aspergillosis on day 30 while receiving caspofungin. Seventeen/19 (89%) patients remain alive at least 7 days after the end of caspofungin administration without documented or suspected fungal, bacterial, or viral infection. Resolution of fever occurred in 11/12 febrile neutropenic patients in a median of 2 days (range:2–13) after starting caspofungin. We conclude that caspofungin is safe and effective as preventive and empirical antifungal treatment of neutropenic allografted patients.

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CT Scan Enumeration of Altered Spleen Status and Pulmonary Artery Size in Patients with Autoimmune Lymphoproliferative Syndrome (ALPS).

Blood ◽

10.1182/blood.v114.22.4034.4034 ◽

2009 ◽

Vol 114 (22) ◽

pp. 4034-4034

Author(s):

Elisabeth Wynne ◽

Katie Perkins ◽

Susan Price ◽

Adeline Louie ◽

V. Koneti Rao

Keyword(s):

Ct Scan ◽

Conflicts Of Interest ◽

Statistical Tests ◽

Pulmonary Arteries ◽

Evaluation Criteria ◽

Statistical Correlation ◽

Ct Scans ◽

P Value ◽

Contingency Table Analysis ◽

Table Analysis

Abstract Abstract 4034 Poster Board III-970 Background ALPS is a disorder of apoptosis resulting in elevated DNT (CD3+, TCRab+, CD4-, CD8-, B220+ double negative T lymphocyte) cells associated with childhood onset nonmalignant lymphadenopathy, splenomegaly and multilineage cytopenias due to splenic sequestration and autoimmune destruction. Patients with ALPS frequently have altered spleen status: splenomegaly or splenectomy, the latter often-related to refractory chronic AIHA and ITP. This altered spleen status has been associated with pulmonary arterial hypertension (PAH) in two patients with ALPS. Though traditionally diagnosed as elevated tricuspid regurgitant jet velocity > 2.6 m/sec, PAH can also be predicted using PA diameter, most commonly measured as the Main PA (MPA) diameter. Similar to Sickle Cell Disease patients who are evaluated for presence of PAH due to functional asplenia here we attempted to further elucidate the relationship between dilated pulmonary arteries (PA) and spleen status in ALPS patients. Methods CT scans of 162 patients with ALPS were studied; their age range at the time of the study was 1-63yrs, median age 16yrs. The CT scans were obtained as part of the routine monitoring of their LPD. Patients' most recent complete chest, abdomen and pelvis CT scans were evaluated. In 97 patients spleen sizes in two scans done 1-12 years apart were also measured. Each scan was evaluated using Kodak Carestream PACS Version 10.1.sp1 software. Point of maximal distension was visually identified in the Main, Left, and Right PA. Artery diameters were measured perpendicular to the vessel wall. Measurement of spleen length consisted of summing the distance between the axial slice in which the spleen first appears to the slice where it appears last. Digital Image Processing (IP) measurements are also underway to compute spleen and liver volumes in these patients. Evaluation Criteria Splenomegaly was defined as a CT estimated spleen length of > 9.76 cm. PA diameter was considered above the upper limits of normal if adults if MPA measured > 28.6 mm LPA > 22.1 mm; RPA> 19.8 mm. For children age specific sizes were adapted from published reports. Results and conclusion In our cohort of 162 ALPS patients, 51% had splenomegaly, 42% had undergone splenectomy due to hypersplenism prior to CT scan evaluations and 7% had normal size spleens. 26% of them demonstrated dilated MPA. However, contingency table analysis yielded a P value = 0.436 (P < 0.05) evaluating an association between splenic abnormalities and dilated MPA. ANOVA analysis of an association between MPA diameter and broad patient classifications of normal spleen, splenectomy, and splenomegaly yielded P = .02 (α < 0.05) and non-significant Tukey HSD statistical tests, the odds ratio = 0.93 for an association between spleen length and MPA diameter. Correlation R2 = 0 between age, spleen length and MPA diameter, though this was only evaluated in 42 patients 17 years and older. Serial measurements of enlarged spleens in the 97 children and adults with at least 2 CT scans done at a median time of 4 yrs apart (range 1-12yrs) showed no further significant increase in spleen size with age. For most patients, their ALPS associated lymphoproliferative burden appears to be worse during early childhood and as they grow older it may become self-limited and stable. Further work is in progress to correlate changes in PA diameter with changes in spleen length, spleen volumes and age. There was no statistical correlation between MPA diameter and altered spleen status, though a quarter of these patients demonstrated dilated pulmonary arteries. Active surveillance for PAH by periodic echocardiograms is underway in these patients. Disclosures: No relevant conflicts of interest to declare.

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Clinical Features and Diagnostic Delay of Tuberculosis (TB) in Patients with Acute Myeloid Leukemia. (AML)

Blood ◽

10.1182/blood-2019-128158 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 5114-5114 ◽

Cited By ~ 1

Author(s):

Veronica Bravo Villa ◽

Emmanuel Martínez Moreno ◽

Nidia Zapata

Keyword(s):

Pulmonary Tuberculosis ◽

Clinical Presentation ◽

Opportunistic Infections ◽

Conflicts Of Interest ◽

Diagnostic Delay ◽

Clinical Signs ◽

Diagnostic Tools ◽

Diagnosis Delay ◽

Persistent Fever ◽

Latent Tb

Introduction Patients with AML are inmmunocompromised because of the disease itself and the use of chemotherapy, increasing endemic opportunistic infections. The main complication is secondary infectious diseases, which we have to consider TB. In cancer patients infected with TB frequently manifest more atypical. Clinical signs and symptoms include lung disease which is still the most commonly involved site, extra pulmonary tuberculosis is not uncommon. Even that we're in an endemic country we still have some delay in the diagnosis of such disease. Objective To characterize the clinical and factors that contributes to the delay on the diagnosis of tuberculosis in patients with AML. Methods We did a chart review of patients with the diagnosis of TB and AML in the Instituto Nacional de Cancerologia, Mexico City, from January 2014 to July 2019. We analyze the clinical presentation of and the time to diagnosis TB in those patients. Results We analyze a cohort of 5 patients, three male and two female with a median age of 44 years old. The majority of patients were on induction chemotherapy. The main clinical presentation was persistent fever that begins in the nadir of chemotherapy. We observed a median of days for the diagnosis of tuberculosis of 37 days (9-82), the diagnosis was made by histopathology supported by special stains, and were required at least two biopsies for the diagnosis. One patient has pulmonary tuberculosis, one nodal presentation, two have a hepatosplenic presentation, and in the last patient was conclude latent TB. Just in one patient was available the microbiological identification, Mycobaterium bovis. Four patients started the approved treatment in Mexico, intensive phase with rifampicin, pyrazinamide, ethambutol and isoniazid. One patient develop Drug induce liver injury (DILI) so she couldn't continue the first line treatment and have to receive the second line which it is not standardize. After the initiation of the treatment, patients went out of fever and improve their condition. The patients were followed during the maintenance phase with rifampicin, and isoniazid. All of the patients are alive at the moment of the study. Conclusion: Febril neutropenia is a common complication in patients with AML, and in patients with persistent fever, tuberculosis should be include in the differential diagnosis. In México we have limited access to all the diagnostic tools available in our center. Culture is not always a way to identify TB, most of our patients were diagnosed by biopsy, median number of procedures were 3. Patient number 5 was followed by the infectology service after the whole protocol of culturing TB were concluded with no evidence of the disease and they decide to stop the treatment, and they manage the patient as latent TB. The availability of the techniques is the main factor which contributes to the diagnosis delay of TB. After the treatment was started, patients have a significant clinical improvement. Disclosures No relevant conflicts of interest to declare.

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CT scan vs nasal endoscopy findings in the diagnosis of chronic rhinosinusitis: our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20191741 ◽

2019 ◽

Vol 5 (3) ◽

pp. 739

Author(s):

Shruti Baruah ◽

Pratibha Vyas ◽

Arpit Srivastava

Keyword(s):

Ct Scan ◽

Chronic Rhinosinusitis ◽

Middle Turbinate ◽

Ct Imaging ◽

Ct Scans ◽

Nasal Endoscopy ◽

Common Finding ◽

Diagnostic Tools ◽

P Value ◽

Significant Difference

Background: Diagnostic nasal endoscopy and CT imaging are both widely used essential diagnostic tools for chronic rhinosinusitis (CRS). This study analyses their individual roles in the management of CRS as well as the degree of correlation between the two.Methods: A prospective observational comparative study was conducted in the Department of Otorhinolaryngology, Mahatma Gandhi Hospital, Jaipur from January, 2017 to June, 2018 on a sample size of 201 patients diagnosed with chronic rhinosinusitis, as per AAOHNS guidelines. DNE and CT PNS were done for all patients enrolled in the study, the findings of each were correlated and their individual sensitivity and specificity for each variable was calculated. Results: On Comparing CT findings with diagnostic nasal endoscopic findings, Polyps were seen in 91 patients’ CT scans as opposed to 124 on DNE. B/L Polyps on CT imaging vs bilateral ethmoidal polyps visualized during DNE revealed a highly significant “P” value; whereas for antrochoanal polyps or unilateral polyps there was no significant difference. Maxillary sinus involvement is the most commonly observed finding in CT scan of PNS in CRS while deviated nasal septum is the most common finding on a diagnostic nasal endoscopy, seen in 60.7%. For anatomical variants like concha bullosa and paradoxical middle turbinate, no significant difference was seen.Conclusions: CT scans and DNE are both key pre-operative diagnostic tools for patients of CRS and both are complementary to each other in detecting type and extent of pathology.

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Dynamic Monitor of CT Scan Within Short Interval in Invasive Pulmonary Aspergillosis for Nonneutropenic Patients

10.21203/rs.3.rs-145899/v1 ◽

2021 ◽

Author(s):

Fei Chen ◽

Yonghong Zhong ◽

Na Li ◽

Huijie Wang ◽

Yanbin Tan ◽

...

Keyword(s):

Ct Scan ◽

Respiratory Diseases ◽

Short Interval ◽

Invasive Pulmonary Aspergillosis ◽

Host Factors ◽

Antifungal Treatment ◽

Ct Scans ◽

Pulmonary Aspergillosis ◽

Life Threatening ◽

American Society

Abstract Background: In nonneutropenic patients with underlying respiratory diseases (URD), invasive pulmonary aspergillosis (IPA) is a life-threatening disease. Yet establishing early diagnosis in those patients remains quite a challenge. Methods :A retrospective series of nonneutropenic patients with probable or proven IPA were reviewed from January 2014 to May 2018 in Department of Respiratory Medicine of two Chinese hospitals. Refer to the relevant diagnostic criteria in the 《American Society of Infectious Diseases Guidelines for Invasive Aspergillus 2008》1. Those patients were suspected of IPA and underwent lung computed tomography (CT) scans twice within 5-21 days. The items required for IPA diagnosis were assessed by their host factors, mycological findings and CT scans according to EORTC/ MSG criteria. Results: Together with the risk factors, mycological findings and nonspecific radiological signs on first CT, ten patients were suspected of IPA. With the appearance of cavities on second CT scan in following days, all patients met the criteria of probable or possible IPA. Except one patient who refused antifungal treatment, nine patients received timely antifungal treatment and recovered well. One of the nine treated IPA cases was further confirmed by pathology, one was confirmed by biopys. Conclusions: Dynamic monitor of CT scan provided specific image evidences for IPA diagnosis. This novel finding might provide a noninvasive and efficient strategy in IPA diagnosis with URD.

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The Efficacy of CT-Diagnostic-Driven Antifungal Strategy with Voriconazole for Invasive Aspergillosis in Patients with Hematological Diseases: A Multicenter, Prospective Study

Blood ◽

10.1182/blood.v128.22.2370.2370 ◽

2016 ◽

Vol 128 (22) ◽

pp. 2370-2370

Author(s):

Yu Ji ◽

Yuqian Sun ◽

Chenhua Yan ◽

Xiaojun Huang ◽

Daihong Liu ◽

...

Keyword(s):

Fungal Infection ◽

Antifungal Therapy ◽

Conflicts Of Interest ◽

Financial Burden ◽

Antifungal Treatment ◽

Successful Outcome ◽

Intensive Chemotherapy ◽

Hematopoietic Stem ◽

Halo Sign ◽

Neutropenic Patients

Abstract Background The frequency of invasive fungal disease (IFD) has increased in recent two decades and has emerged as an important cause of life-threatening infections in immunocompromised patients, especially in those who have undergone allogeneic hematopoietic stem cell transplantation (HSCT). Empirical antifungal therapy has been the standard of care used to decrease the number of deaths due to IFD among neutropenic patients who have persistent or recurrent fever despite broad-spectrum antibacterial treatment. However, about two thirds of these patients may be potentially exposed to unnecessary empirical antifungal treatment with associated potential toxicity and considerable financial burden. It was demonstrated that high-resolution computerized tomography (HRCT) had early predictive value for fungal infection, and the major signs on chest CT scans generally precede the positive outcome of serum galactomannan test. It was also shown that the diagnosis-based treatment strategy only based on HRCT results could reduce more than a half use of antifungal agents in HSCT patients who had persistent febrile neutropenia. Thus, we would like to explore the feasibility of this new strategy for hematological patients with IA in China. Method This was a prospective and single-arm study. Up to now, 24 neutropenic patients after intensive chemotherapy or HSCT with high risk factors for IFD from three hospitals were enrolled. After recruitment, HRCT of thorax will be conducted within 24h. If HRCT shows any new changes suspicious of fungal infection, including halo sign, cavity, air-crescent sign, or other non-specific signs, voriconazole would be given intravenously for two weeks, followed by oral voriconazole. Six weeks after initiation of antifungal therapy, the outcome was evaluated by clinicians according to the patients' imagining and microbiological evidences and clinical conditions, and complete or partial responses were defined as successful outcome of antifungal therapy. Result The median age of this population was 38.5 years (range from 19 to 78). Four of 24 patients were the recipients of HSCT, and the others received intensive chemotherapy. There were four patients had history of IFD, and 7 take fluconazole orally for antifungal prophylaxis. At the beginning of antifungal therapy with voriconazole, 12 had non-specific infiltrates on pulmonary HRCT, 8 had dense lesions with halo sign, and 4 had cavity. At the end of six-week follow-up, 5 patients were diagnosed with possible IA, 6 with probable IA and 1 with proven IA. The total successful rate of antifungal therapy with CT-diagnostic-driven strategy was 50.0% (12/24). Notably, efficacies of the antifungal treatment in patients with specific IA signs on pulmonary HRCT were significant higher than that in patients with non-specific signs (75.0% vs. 25.0%, P=0.043). Conclusion The CT-diagnostic-driven antifungal strategy was effective and suitable for patients with hematological malignancies. Disclosures No relevant conflicts of interest to declare.

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Feature-Based Registration of Thorax CT Scan Slices

Informatica ◽

10.15388/informatica.2017.137 ◽

2017 ◽

Vol 28 (3) ◽

pp. 439-452

Author(s):

Mykolas J. Bilinskas ◽

Gintautas Dzemyda ◽

Mantas Trakymas

Keyword(s):

Ct Scan ◽

Feature Based ◽

Thorax Ct

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Clinico-bacteriological Profile and Outcome of Empyema Thoracis in Children at a Tertiary Care Hospital of Central Nepal

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v16i3.30661 ◽

2020 ◽

Vol 16 (3) ◽

Author(s):

Atanu Pan ◽

Debarshi Jana

Keyword(s):

Ct Scan ◽

Broad Spectrum ◽

Chest Tube ◽

Chest Tube Drainage ◽

Diagnostic Tools ◽

High Morbidity ◽

Care Hospital ◽

Empyema Thoracis ◽

First Line ◽

Tube Drainage

Background: Empyema thoracis (ET) is a serious infection of the pleural space. Despite the availability of broad spectrum antibacterial, improved vaccination coverage and better diagnostic tools, Empyema Thoracis remains associated with high morbidity worldwide. Delay in early diagnosis, failure to institute appropriate antimicrobial therapy, multidrug resistant organisms, malnutrition, comorbidities, poor health seeking behaviour and high treatment cost burden contribute to increased morbidity in children. The available treatment options include intravenous broad-spectrum antibiotics either alone or in combination with surgical procedure (thoracocentesis, chest tube drainage, fibrinolytic therapy, decortications with video assistedthoracoscopic surgery (VATS) and open drainage. Methods: Fifty Children between 1 month to 16 years admitted in the Pediatrics Ward, PICU of College of Medical Sciences, Bharatpur,Nepal. Data analysis was done by SPSS 24.0. Results: Present study found that according to blood culture, 3(6.0%) patients had enterococcus, 40(80.0%) patients had no growth, 2(4.0%) patients had pseudomonas, 4(8.0%) patients had staphylococcus and 1(2.0%) patients had streptococcus. We found that 20(40.0%) patients had done CT scan thorax, 30(60.0%) patients had not done CT scan thorax and 32(64.0%) patients had Amoxiclav first line antibiotic and 18(36.0%) patients had Ceftriaxone first line antibiotic. Conclusions: Suitable antibiotics and prompt chest tube drainage is an effective method of treatment of childhood empyema, especially in resource-poor settings. Majority of the patients progress on this conservative management and have good recovery on follow up.

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Diagnostic Accuracy of Magnetic Resonance Imaging and Computed Tomography Scan in Young Athletes With Spondylolysis

Clinical Pediatrics ◽

10.1177/0009922819832643 ◽

2019 ◽

Vol 58 (6) ◽

pp. 671-676

Author(s):

Amy M. West ◽

Pierre A. d’Hemecourt ◽

Olivia J. Bono ◽

Lyle J. Micheli ◽

Dai Sugimoto

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Ct Scan ◽

False Negative ◽

False Negative Rate ◽

Ct Scans ◽

Resonance Imaging ◽

Young Athletes ◽

Negative Rate

The objective of this study was to determine diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) scans in young athletes diagnosed with spondylolysis. A cross-sectional study was used. Twenty-two young athletes (14.7 ± 1.5 years) were diagnosed as spondylolysis based on a single-photon emission CT. Following the diagnosis, participants underwent MRI and CT scan imaging tests on the same day. The sensitivity and false-negative rate of the MRI and CT scans were analyzed. MRI test confirmed 13 (+) and 9 (−) results while CT test showed 17 (+) and 5 (−) results. The sensitivity and false-negative rate of MRI were, respectively, 59.1% (95% confidence interval [CI] = 36.7% to 78.5%) and 40.9% (95% CI = 21.5% to 63.3%). Furthermore, the sensitivity and false-negative rate of CT scan were 77.3% (95% CI = 54.2% to 91.3%) and 22.7% (95% CI = 0.09% to 45.8%). Our results indicated that CT scan is a more accurate imaging modality to diagnose spondylolysis compared with MRI in young athletes.

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