scholarly journals Multiparametric multidetector computed tomography scanning on suspicion of hyperacute ischemic stroke: validating a standardized protocol

2013 ◽  
Vol 71 (6) ◽  
pp. 349-356 ◽  
Author(s):  
Felipe Torres Pacheco ◽  
Antonio Jose da Rocha ◽  
Ingrid Aguiar Littig ◽  
Antonio Carlos Martins Maia Junior ◽  
Rubens Jose Gagliardi
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Multidetector Computed Tomography ◽  
Global Analysis ◽  
Observer Agreement ◽  
Perfect Agreement ◽  
Standardized Protocol ◽  
Computed Tomography Scanning ◽  
Reproducible Analysis ◽  
Map Data

Multidetector computed tomography (MDCT) scanning has enabled the early diagnosis of hyperacute brain ischemia. We aimed at validating a standardized protocol to read and report MDCT techniques in a series of adult patients. The inter-observer agreement among the trained examiners was tested, and their results were compared with a standard reading. No false positives were observed, and an almost perfect agreement (Kappa>0.81) was documented when the CT angiography (CTA) and cerebral perfusion CT (CPCT) map data were added to the noncontrast CT (NCCT) analysis. The inter-observer agreement was higher for highly trained readers, corroborating the need for specific training to interpret these modern techniques. The authors recommend adding CTA and CPCT to the NCCT analysis in order to clarify the global analysis of structural and hemodynamic brain abnormalities. Our structured report is suitable as a script for the reproducible analysis of the MDCT of patients on suspicion of ischemic stroke.

Is multidetector computed tomography comparable to magnetic resonance imaging for assessment of lumbar foraminal stenosis?

2016 ◽  
Vol 58 (2) ◽  
pp. 197-203
Author(s):  
Woo Young Kang ◽  
Joong Mo Ahn ◽  
Joon Woo Lee ◽  
Eugene Lee ◽  
Yun Jung Bae ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Multidetector Computed Tomography ◽  
Excellent Agreement ◽  
Observer Agreement ◽  
Kappa Statistics ◽  
Foraminal Stenosis ◽  
Resonance Imaging ◽  
Lumbar Foraminal Stenosis

Background Both multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are used for assessment of lumbar foraminal stenosis (LFS). Therefore, it is relevant to assess agreement between these imaging modalities. Purpose To determine intermodality, inter-, and intra-observer agreement for assessment of LFS on MDCT and MRI. Material and Methods A total of 120 foramina in 20 patients who visited our institution in January and February 2014 were evaluated by six radiologists with different levels of experience. Radiologists evaluated presence and severity of LFS on sagittal CT and MR images according to a previously published LFS grading system. Intermodality agreement was analyzed by using weighted kappa statistics, while inter- and intra-observer agreement were analyzed by using intraclass correlation coefficients (ICCs) and kappa statistics. Results Overall intermodality agreement was moderate to good (kappa, 0.478–0.765). In particular, two professors and one fellow tended to overestimate the degree of LFS on CT compared with MRI. For inter-observer agreement of all six observers, ICCs indicated excellent agreement for both CT (0.774) and MRI (0.771), while Fleiss’ kappa values showed moderate agreement for CT (0.482) and MRI (0.575). There was better agreement between professors and fellows compared with residents. For intra-observer agreement, ICCs indicated excellent agreement, while kappa values showed good to excellent agreement for both CT and MRI. Conclusion MDCT was comparable to MRI for diagnosis and assessment of LFS, especially for experienced observers. However, there was a tendency to overestimate the degree of LFS on MDCT compared with MRI.

Role of Cardiac Multidetector Computed Tomography in Acute Ischemic Stroke: A Preliminary Report

2010 ◽  
Vol 29 (4) ◽  
pp. 313-320 ◽  
Author(s):  
Sang-Bae Ko ◽  
Sang Il Choi ◽  
Eun Ju Chun ◽  
Youngchai Ko ◽  
Jung-Hyun Park ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Multidetector Computed Tomography ◽  
Preliminary Report

scholarly journals Value of Multidetector Computed Tomography in the Assessment of Achalasia Subtypes and Detection of Pulmonary and Thoracic Complications

2019 ◽  
Vol 28 (6) ◽  
pp. 539-546
Author(s):  
Sanja Jovanovic ◽  
Aleksandra Djuric-Stefanovic ◽  
Aleksandar Simić ◽  
Ognjan Skrobic ◽  
Predrag Pesko
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Wall Thickness ◽  
Imaging Modality ◽  
Correlation Coefficients ◽  
Observer Agreement ◽  
Esophageal Wall ◽  
X Ray ◽  
Chest X Ray ◽  
Diagnostic Work

Objective: To evaluate multidetector computed tomography (MDCT) findings in patients with achalasia, to assess its role in differentiating subtypes in detecting lung involvement and extra-esophageal thoracic complications. Subjects and Methods: This clinical retrospective study included 51 patients with manometrically confirmed achalasia who underwent chest X-ray and MDCT in diagnostic work-up. Esophageal wall thickness and morphology, luminal dilatation, lung changes, and extra-esophageal manifestations were analyzed on MDCT by 2 readers. Wilcoxon, Kruskal-Wallis and Mann-Whitney test were used for assessing the differences among the achalasia subtypes, and intra-class correlation coefficients (ICC) assessing the inter-observer agreement between the measurements of 2 readers. Results: Fourteen (27.5%) patients had achalasia subtype I, 21 (60.8%) had subtype II while 6 (11.8%) had subtype III. Esophageal wall thickness of the esophageal body (EB) and distal esophageal segment (DES) as well as nodular/lobulated appearance of DES were found significantly more often in subtype III (p = 0.024, p < 0.001, p = 0.009, respectively). Esophageal dilatation gradually decreased from subtype I to III (p = 0.006). Chest X-ray revealed lung changes in 9 (17%) and MDCT in 21 (41%) patients (p = 0.001), most frequently in subtype I, with predominance of ground-glass opacities. Tracheal/carinal compression was detected in 27 (52.9%) and left atrial compression in 17 (33.3%) patients. Excellent inter-observer agreement was observed in measuring the EB and DES wall thickness, and diameter of EB (ICC 0.829, 0.901, and 0.922). Conclusion: MDCT is a useful tool for detecting lung and extra-esophageal thoracic complications in patients with achalasia, and could be a valuable additional imaging modality in the differentiation of achalasia subtypes.

scholarly journals A Parallel Thrombolysis Protocol with Nurse Practitioners As Coordinators Minimized Door-to-Needle Time for Acute Ischemic Stroke

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Sheng-Feng Sung ◽  
Ying-Chieh Huang ◽  
Cheung-Ter Ong ◽  
Yu-Wei Chen
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Median Time ◽  
Nurse Practitioners ◽  
Stroke Patients ◽  
Study Objective ◽  
Stroke Team ◽  
Computed Tomography Scanning ◽  
Tomography Scanning

Introduction. Quick thrombolysis after stroke improved clinical outcomes. The study objective was to shorten door-to-needle time for thrombolysis.Methods. After identifying the sources of in-hospital delays, we developed a protocol with a parallel algorithm and recruited nurse practitioners into the acute stroke team. We applied the new protocol on stroke patients from October 2009 to September 2010. Patients from the previous two years were used for comparison.Results. For ischemic stroke patients within 3 hours of onset, the median time from arrival to computed tomography scanning was reduced from 29 to 20 minutes () and the median time from arrival to neurology evaluation decreased from 61 to 43 minutes (). For those patients who received thrombolysis, the median door-to-needle time was shortened from 68.5 to 58 minutes ().Conclusions. The parallel thrombolysis protocol successfully improved the median door-to-needle time to below the guideline-recommended 60 minutes.

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