DIAGNOSTIC ACCURACY OF MRCP IN EVALUATION OF PERIAMPULLARY DUODENAL DIVERTICULA – PROSPECTIVE STUDY

Background and Objectives: Duodenal diverticula are a common finding in patients with biliary tract disorders. The objective of this study is to assess the diagnostic value of the magnetic resonance cholangiopancreatography (MRCP) in case of periampullary duodenal diverticula (PAD) using endoscopic cholangiopancreatography (ERCP) as a reference method. Methods: The study population included 350 patients with known or suspected diseases of the biliary tract, liver, and pancreas. Two radiologists interpreted the image quality and the presence of PAD in agreement . Results: In cases with a single PAD, MRCP had sensitivity 81.2%, specificity 98.6%, positive predictive value 90.9%, and negative predictive value 97%, compared to ERCP. In the case with two PAD, MRCP had sensitivity 40%, specificity 99.7%, positive predictive value 66.7% and negative predictive value 98.9%. The average volume of PAD was 3.25 cm3. In this study group patients with PAD were on average 10 years older than those without PAD (< 0.001). There was also found a significant association of PAD with choledocholithiasis (p = 0.009) and cholecystitis (p = 0.002). Interpretation and Conclusions: In conclusion, MRCP could be used as a non-invasive diagnostic modality with acceptable sensitivity and specificity in patients with suspected PAD and biliary tract diseases.

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Role of ascitic fluid adenosine deaminase (ADA) and serum CA-125 in the diagnosis of tuberculous peritonitis

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v40i3.25228 ◽

2015 ◽

Vol 40 (3) ◽

pp. 89-91 ◽

Cited By ~ 5

Author(s):

N Ali ◽

NC Nath ◽

R Parvin ◽

A Rahman ◽

TM Bhuiyan ◽

...

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Ascitic Fluid ◽

Predictive Value ◽

Ca 125 ◽

Histopathological Diagnosis ◽

Diagnostic Modality ◽

Cross Sectional

This cross sectional study was carried out in the department of gastroenterology, BIRDEM, Dhaka from January 2010 to May 2011 to determine the role of ascitic fluid ADA and serum CA-125 in the diagnosis of clinically suspected tubercular peritonitis. Total 30 patients (age 39.69±21.26, 18M/12F) with clinical suspicion of tuberculosis peritonitis were included in this study after analyzing selection criteria. Laparoscopic peritoneal biopsy with histopathological diagnosis was considered gold standard against which accuracics of two biomarkers (ADA & CA-125) were compared. Cut off value of ADA and CA-125 are 24 u/l, 35 U/ml respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ADA as a diagnostic modality in tuberculos peritonitis were 87.5%, 83.33%, 95.45%, 62.5% and 86.67% respectively where as CA-125 was found to have 83.33% sensitivity, 50% specificity, 86.9% positive predictive value, 42.85% negative predictive value and 76.6% accuracy. Both biomarkers are simple, non-invasive, rapid and relatively cheap diagnostic test where as laparoscopy is an invasive procedure, costly & requires trained staff and not without risk and also not feasible in all the centre in our country. So ascitic fluid ADA and serum CA-125 are important diagnostic test for peritoneal tuberculosis.Bangladesh Med Res Counc Bull 2014; 40 (3): 89-91

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Comparison of transvaginal and transabdominal ultrasonography in the diagnosis of ectopic pregnancy

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v39i3.20309 ◽

2014 ◽

Vol 39 (3) ◽

pp. 104-108 ◽

Cited By ~ 1

Author(s):

MN Nahar ◽

MA Quddus ◽

A Sattar ◽

M Shirin ◽

A Khatun ◽

...

Keyword(s):

Positive Predictive Value ◽

Ectopic Pregnancy ◽

Negative Predictive Value ◽

Predictive Value ◽

Transvaginal Ultrasonography ◽

Histopathological Diagnosis ◽

College Hospital ◽

Diagnostic Modality ◽

Cross Sectional ◽

Transabdominal Ultrasonography

This cross sectional study was carried out in the department of Radiology and Imaging, Dhaka Medical College Hospital from July 2008 to June 2010 to compare the accuracy of transvaginal ultrasonography and transabdominal ultrasonography in the diagnosis of clinically suspected cases of ectopic pregnancy. Initially 60 patients with clinical suspicion of ectopic pregnancy were included in this study after analyzing selection criteria 30 patients underwent both transvaginal and transabdominal ultrasonography. Histopathological diagnosis was considered gold standard against which accuracies of two diagnostic modalities were compared. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transabdominal ultrasonography as a diagnostic modality in evaluation of suspected ectopic pregnancy were 73.1%, 75%, 95%, 30% and 73.3% respectively where as transvaginal ultrasonography was found to have 92.3% sensitivity, 75% specificity, 96% positive predictive value, 60% negative predictive value and 90% accuracy. Transvaginal ultrasonography was superior to transabdominal ultrasonography in the evaluation of suspected ectopic pregnancies .so, transvaginal ultrasonography is important for early and accurate diagnosis of ectopic pregnancy. DOI: http://dx.doi.org/10.3329/bmrcb.v39i3.20309 Bangladesh Med Res Counc Bull 2013; 39: 104-108

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Pancreatin-Cetyl Pyridinium Chloride Digestion and Decontamination Method; A Novel, Sensitive, Cost-Effective Method for Culturing Mycobacterium tuberculosis

Microorganisms ◽

10.3390/microorganisms9102025 ◽

2021 ◽

Vol 9 (10) ◽

pp. 2025

Author(s):

Pottathil Shinu ◽

Anroop B. Nair ◽

Snawar Hussain ◽

Mohamed A. Morsy ◽

Wafaa E. Soliman

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Cetylpyridinium Chloride ◽

Reference Method ◽

Cost Effective ◽

Mycobacterial Species ◽

Direct Microscopy ◽

Cost Effective Method ◽

Cetyl Pyridinium

The present study evaluated the performance of newly developed pancreatin-cetylpyridinium chloride (pancreatin-CPC) digestion and decontamination method (DDM) with N-acetyl L-Cysteine-sodium hydroxide (NALC-NaOH) DDM for isolation of Mycobacteria from clinically suspected pulmonary tuberculosis (PTB) patients. For the study, sputum samples (n = 613) obtained from clinically suspected PTB cases were subjected to direct microscopy, pretreatment with NALC-NaOH DDM (reference method), and pancreatin-CPC DDM followed by culture, and the data were analyzed. The direct microscopy illustrated diagnostic accuracies of 60.4% (sensitivity), 99.77% (specificity), 98.9% (positive predictive value) and 88.3% (negative predictive value), respectively (against culture) for the detection of Mycobacterial species. The pancreatin-CPC DDM showed competitive diagnostic accuracies (against NALC-NaOH DDM) of 99.32% (sensitivity), 94.07% (specificity), 85.05% (positive predictive value), and 99.76% (negative predictive value), respectively, for the isolation of Mycobacterial species. In conclusion, pancreatin-CPC DMM was a highly sensitive, technically simple, and cost-effective method, suggesting its competence to substitute the currently used NALC-NaOH DDM.

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Modified alvarado score in diagnosis of acute appendicitis: a clinicopathological study

International Surgery Journal ◽

10.18203/2349-2902.isj20180415 ◽

2018 ◽

Vol 5 (3) ◽

pp. 878

Author(s):

Sanjay Jain ◽

Ajay Gehlot ◽

M. C. Songra

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Scoring System ◽

Alvarado Score ◽

Diagnostic Modality ◽

Delay In Diagnosis ◽

Modified Alvarado Score

Background: Acute appendicitis is one of the commonest surgical emergencies in all ages. Diagnosis is mainly clinical, delay in diagnosis definitely increases the morbidity, mortality and cost of treatment, more aggressive surgical approach has resulted in increased white appendectomies.Methods: A total 100 cases hospitalized with abdominal pain, suggestive of acute appendicitis on the basis of modified Alvarado scoring system and were subsequently operated, were included in the present study in our institute for period of 20 Months.Results: Males belonging to young age group of 21-30 were most commonly affected. Abdominal pain was seen in 100% of patients. Fever seen in 87% of patients and vomiting in78%. Modified Alvarado score of 9 had positive predictive value of 100% while negative predictive value 8.9%, while score between 7-8 had positive predictive value of 98.9% and negative predictive value 27.8%. The sensitivity was 86.1% and specificity was 83.3%. The ultrasonography showed a sensitivity of 94.68%. In present study rate of total white appendectomy was 6%. The Modified Alvarado scoring system is a reliable and practicable diagnostic modality to increase the accuracy in diagnosis of acute appendicitis and thus to minimise unnecessary appendectomy.Conclusions: Young males are most commonly affected almost always presents with abdominal pain. The Modified Alvarado scoring system is a reliable and practicable diagnostic modality to increase the accuracy in diagnosis of acute appendicitis and thus to minimise unnecessary appendectomy.

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The Overall Poor Specificity of MRCP in the Preoperative Evaluation of the Jaundiced Patient Will Increase the Incidence of Nontherapeutic ERCP

The American Surgeon ◽

10.1177/0003134820942139 ◽

2020 ◽

Vol 86 (8) ◽

pp. 1022-1025

Author(s):

Andrew M. O’Neill ◽

Keith Anderson ◽

Lorinda K. Baker ◽

Michael J. Schurr

Keyword(s):

Laparoscopic Cholecystectomy ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Preoperative Evaluation ◽

Common Bile Duct Stones ◽

Magnetic Resonance Cholangiopancreatography ◽

Advantages And Disadvantages ◽

Patient Will

Laparoscopic cholecystectomy remains one of the most common surgical operations. Common bile duct stones (CBDS) are estimated to be present in 10%-20% of individuals with symptomatic gallstones. Preoperative magnetic resonance cholangiopancreatography (MRCP) and intraoperative cholangiography (IOC) remain the most common methods of evaluation, with subsequent endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction if positive for CBDS. We examined our experience with preoperative MRCP versus IOC for the management of the jaundiced patient with cholelithiasis. This is a retrospective single-institution study that examined all laparoscopic cholecystectomies performed over a 15-month period between 2017 and 2018. Outpatient elective cases were excluded from the analysis. Charts were reviewed for demographics, operative details, and whether an MRCP, IOC, or ERCP was performed. Data were evaluated using a 2-sample t-test. A total of 460 patients underwent laparoscopic cholecystectomy over a 15-month period. Of those, 147 underwent either an MRCP or an IOC for clinical suspicion for CBDS. ERCP after MRCP was nontherapeutic in 11/32 (34%) compared with 2/12 (17%) of patients following IOC. The sensitivity and specificity of MRCP were 91% and 80%, respectively, with a positive predictive value of 66% and a negative predictive value of 96%. The sensitivity and specificity of IOC were 83% and 97%, respectively, with a positive predictive value of 83% and a negative predictive value of 97%. MRCP and IOC have unique advantages and disadvantages. MRCP has greater sensitivity, but poor specificity, resulting in unnecessary ERCPs with associated morbidity and increased costs to the patient.

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Ultrasonography (USG) diagnostic test compared to magnetic resonance cholangio pancreatografy (MRCP) in patients with obstructive jaundice in Dr. Moewardi Public Hospital

GSC Advanced Research and Reviews ◽

10.30574/gscarr.2020.05.2.0107 ◽

2020 ◽

Vol 5 (2) ◽

pp. 167-171

Author(s):

Rachmi Fauziah Rahayu ◽

Luths Maharina ◽

Yuyun Yueniwati

Keyword(s):

Magnetic Resonance ◽

Obstructive Jaundice ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Sensitivity And Specificity ◽

Biliary Tract ◽

Predictive Value ◽

Public Hospital ◽

Biliary Tract Tumors

Background: Ultrasonography (USG) is still the first imaging modality for initial examination in patients with obstructive jaundice. Abdominal ultrasonography is quite good in seeing the morphology of the biliary tract, although the diagnostic etiological sensitivity of various causes of obstruction is very low. Magnetic resonance cholangio pancreatography (MRCP) is a new technique and can show the same picture as ERCP examination and no contrast media is needed. Aim: Aim for this study is knowing the results of ultrasound diagnostic tests in detecting Obstruction jaundice which was confirmed by the results of MRCP examination at Dr. Moewardi public hospital. Method: This study uses a diagnostic test that assesses sensitivity, big specifications, negative predictive value and positive predictive value of ultrasound in detecting jaundice obstruction confirmed by the results of the MRCP examination. Sampling was done by purposive sampling, on 68 research subjects. Results: This study show the characteristics of jaundice in the form of stones with sensitivity and specificity values of 84% and 83%, positive predictive value 75% and negative predictive value 90% and in biliary tract tumors 83% and 84%, positive predictive value 75% and predictive value negative 90%. Conclusions: Ultrasound has a high sensitivity and specificity value in diagnosing obstructive jaundice in the case of biliary tract stones and biliary tract tumors

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Mammographic Diagnosis of Breast Carcinoma: An Institutional Experience

Journal of Nepal Medical Association ◽

10.31729/jnma.312 ◽

2008 ◽

Vol 47 (170) ◽

Author(s):

Dr Sidharth ◽

B Thapa ◽

Y Singh ◽

P Sayami ◽

U Khanal

Keyword(s):

Breast Carcinoma ◽

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Negative Predictive Value ◽

Predictive Value ◽

Premenopausal Women ◽

Benign Lesions ◽

Diagnostic Modality ◽

Institutional Experience ◽

Very High

Mammogram is a common diagnostic modality for breast carcinoma. Diagnostic mammogramis available at only few centers in Nepal. The aim of this study was to determine the accuracy ofdiagnostic mammogram in Nepalese women suffering from breast carcinoma. A retrospectiveanalysisofthebreast carcinomawas carriedoutintheDepartmentof Surgery,TribhuwanUniversityTeaching Hospital from October 1995 to October 2007. Out of 556 patients with histologically proven breast carcinoma, 378 patients (68%) had undergone mammography. Breast carcinoma was identified on mammography in 328 (87%) cases while 50 cases (13%) were reported as normal or benign lesions. Diagnostic mammogram had a sensitivity of 86.8%, a specificity of 98.6% with a positive predictive value of 68.8% and a negative predictive value of 99.5%. In mammographically missed breast carcinoma, 34% were less than 40 years of age (P<0.05), 60% were premenopausal (P<0.05) and 88% patients presented with a painless lump. The study shows that the diagnostic accuracy of the mammogram is very high. However, there is a chance of missing the breast carcinoma in youngand premenopausal women.Key words: breast carcinoma, diagnostic mammogram, premenopausal women

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Diagnostic value of transabdominal hydrosonography in gastric carcinoma

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v10i3.8360 ◽

1970 ◽

Vol 10 (3) ◽

pp. 170-176

Author(s):

AF Rabbi ◽

RN Sarker ◽

A Hossain

Keyword(s):

Gastric Carcinoma ◽

Positive Predictive Value ◽

Key Words ◽

Negative Predictive Value ◽

Predictive Value ◽

Diagnostic Value ◽

Clinical Suspicion ◽

Diagnostic Modality ◽

Key Words Gastric Carcinoma ◽

Sensitivity Specificity

Aim: To evaluate the efficacy of transabdominal hydrosonography in the diagnosis of gastric carcinoma. Materials and Methods: Transabdominal hydrosonography of the stomach was carried out on fifty patients with clinical suspicion of gastric carcinoma. Endoscopic or peroperative biopsy was taken from pathological sites in all cases. The validity of transabdominal hydrosonography of the stomach was evaluated as compared to histopathological diagnoses. Results: The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of transabdominal hydrosonography in the diagnosis of gastric carcinoma were 81.82%, 96.43%, 90.00%, 94.74% & 87.10% respectively. Conclusion: Transabdominal hydrosonography is a useful diagnostic modality for the diagnosis of gastric carcinoma. Key words: Gastric carcinoma, transabdominal hydrosonography. DOI: http://dx.doi.org/ 10.3329/bjms.v10i3.8360 BJMS 2011; 10(3): 170-176

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Added value of diffusion-weighted MRI in assessment of pleural lesions

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00557-3 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Youssriah Yahia Sabri ◽

Ikram Hamed Mahmoud ◽

Lamis Tarek El-Gendy ◽

Mohamed Raafat Abd El-Mageed ◽

Sally Fouad Tadros

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Diagnostic Value ◽

Added Value ◽

Adc Value ◽

Pleural Diseases ◽

Conventional Mri ◽

Malignant Lesions

Abstract Background There are many causes of pleural disease including variable benign and malignant etiologies. DWI is a non-enhanced functional MRI technique that allows qualitative and quantitative characterization of tissues based on their water molecules diffusivity. The aim of this study was to evaluate the diagnostic value of DWI-MRI in detection and characterization of pleural diseases and its capability in differentiating benign from malignant pleural lesions. Results Conventional MRI was able to discriminate benign from malignant lesions by using morphological features (contour and thickness) with sensitivity 89.29%, specificity 76%, positive predictive value 89%, negative predictive value 76.92%, and accuracy 85.37%. ADC value as a quantitative parameter of DWI found that ADC values of malignant pleural diseases were significantly lower than that of benign lesions (P < 0.001). Hence, we discovered that using ADC mean value of 1.68 × 10-3 mm2/s as a cutoff value can differentiate malignant from benign pleural diseases with sensitivity 89.3%, specificity 100%, positive predictive value 100%, negative predictive value 81.2%, and accuracy 92.68% (P < 0.001). Conclusion Although DWI-MRI is unable to differentiate between malignant and benign pleural effusion, its combined morphological and functional information provide valid non-invasive method to accurately characterize pleural soft tissue diseases differentiating benign from malignant lesions with higher specificity and accuracy than conventional MRI.

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Accuracy of Medical Examiner’s Assessment for Near–Real-Time Surveillance of Fatal Drug Overdoses, King County, Washington, March 2017–February 2018

Public Health Reports ◽

10.1177/00333549211008455 ◽

2021 ◽

pp. 003335492110084

Author(s):

Kirsten Vannice ◽

Julia Hood ◽

Nicole Yarid ◽

Meagan Kay ◽

Richard Harruff ◽

...

Keyword(s):

Public Health ◽

Positive Predictive Value ◽

Real Time ◽

Negative Predictive Value ◽

Drug Overdose ◽

Predictive Value ◽

Death Certificate ◽

King County ◽

Public Health Response ◽

Drug Overdoses

Objectives Up-to-date information on the occurrence of drug overdose is critical to guide public health response. The objective of our study was to evaluate a near–real-time fatal drug overdose surveillance system to improve timeliness of drug overdose monitoring. Methods We analyzed data on deaths in the King County (Washington) Medical Examiner’s Office (KCMEO) jurisdiction that occurred during March 1, 2017–February 28, 2018, and that had routine toxicology test results. Medical examiners (MEs) classified probable drug overdoses on the basis of information obtained through the death investigation and autopsy. We calculated sensitivity, positive predictive value, specificity, and negative predictive value of MEs’ classification by using the final death certificate as the gold standard. Results KCMEO investigated 2480 deaths; 1389 underwent routine toxicology testing, and 361 were toxicologically confirmed drug overdoses from opioid, stimulant, or euphoric drugs. Sensitivity of the probable overdose classification was 83%, positive predictive value was 89%, specificity was 96%, and negative predictive value was 94%. Probable overdoses were classified a median of 1 day after the event, whereas the final death certificate confirming an overdose was received by KCMEO an average of 63 days after the event. Conclusions King County MEs’ probable overdose classification provides a near–real-time indicator of fatal drug overdoses, which can guide rapid local public health responses to the drug overdose epidemic.

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