scholarly journals Intra and interobserver reliability of the interpretation of high-resolution computed tomography on the lungs of premature infants

2010 ◽  
Vol 128 (3) ◽  
pp. 130-136 ◽  
Author(s):  
Márcia Cristina Bastos Boëchat ◽  
Rosane Reis de Mello ◽  
Maria Virgínia Peixoto Dutra ◽  
Kátia Silveira da Silva ◽  
Pedro Daltro ◽  
...  

CONTEXT AND OBJECTIVE: High-resolution computed tomography (HRCT) of the lungs is more sensitive than radiographs for evaluating pulmonary disease, but little has been described about HRCT interpretation during the neonatal period or shortly afterwards. The aim here was to evaluate the reliability of the interpretation of HRCT among very low birth weight premature infants (VLBWPI; < 1500 g). DESIGN AND SETTING: Cross-sectional study on intra and interobserver reliability of HRCT on VLBWPI. METHODS: 86 VLBWPI underwent HRCT. Two pediatric radiologists analyzed the HRCT images. The reliability was measured by the proportion of agreement, kappa coefficient (KC) and positive and negative agreement indices. RESULTS: For radiologist A, the intraobserver reliability KC was 0.79 (confidence interval, CI: 0.54-1.00) for normal/abnormal examinations; for each abnormality on CT, KC ranged from 0.05 to 1.00. For radiologist B, the intraobserver reliability KC was 0.79 (CI: 0.54-1.00) for normal/abnormal examinations; for each abnormality on CT, KC ranged from 0.37 to 0.83. The interobserver agreement was 88% for normal/abnormal examinations and KC was 0.71 (CI: 0.5- 0.93); for most abnormal findings, KC ranged from 0.51-0.67. CONCLUSION: For normal/abnormal examinations, the intra and interobserver agreements were substantial. For most of the imaging findings, the intraobserver agreement ranged from moderate to substantial. Our data demonstrate that in clinical practice, there is no reason for more than one tomographic image evaluator, provided that this person is well trained in VLBWPI HRCT interpretation. Analysis by different observers should be reserved for research and for difficult cases in clinical contexts.

2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19


2021 ◽  
Vol 8 (17) ◽  
pp. 1127-1132
Author(s):  
Nikunj C. Desai ◽  
Nilesh P. Parkar ◽  
Asutosh N. Dave

BACKGROUND Interstitial lung disease (ILD) is an unpredictable diffuse parenchymal lung disease, which involves interstitium of lung (tissue around the alveoli of the lungs). High resolution computed tomography (HRCT) is one of the confirmatory, easily accessible methodology for the conclusion and follow up assessment of interstitial lung disease. We wanted to study the normal HRCT patterns found with interstitial lung disease and contrastingly different HRCT designs and clinical information in differential determination of pulmonary fibrosis. We also wanted to study the different patterns of interstitial lung disease on high resolution computed tomography and thereby provide accurate diagnosis and management to the patients. METHODS The study was a hospital based prospective, cross sectional study. In the present study, total fifty patients referred from Department of Medicine and Department of Pulmonary Medicine of GCS Medical College having suspicion of interstitial lung disease were studied from April 2019 to September 2019. All patients underwent HRCT thorax on 16 slice Siemens computerised tomography (CT) scan machine in recumbent position utilising usual HRCT protocol. Lung abnormalities were noticed and classified for explicit diagnosis of interstitial lung pathologies. RESULTS Most of the patients (N = 25) were found to be in the age group of 50 - 80 years (17 female & 8 male). Progressive dyspnoea (N = 47; 94 %) was the most common chief complaint. The most common form of interstitial lung disease was usual interstitial pneumonia (UIN) (N = 18; 36 %) in our study. Acute interstitial pneumonia (AIP) (N = 7; 14 %) and non-specific interstitial pneumonia, NSIP (N = 7; 14 %) were the next common interstitial lung diseases. CONCLUSIONS The most well-known interstitial lung disease seen in our examination was usual interstitial pneumonia. Cases of interstitial lung disease are on the rise. Interstitial lung disease should be ruled out in all patients with progressive dyspnoea, particularly when there are no obvious or known causes of dyspnoea. Clinical and laboratory findings, pulmonary function tests, history of exposure along with HRCT workup is indispensable for the identification or exclusion of interstitial lung disease. HRCT is also useful for the follow-up study. KEYWORDS Acute Interstitial Pneumonia (AIP), High Resolution Computed Tomography (HRCT), Interstitial Lung Disease (ILD), Nonspecific Interstitial Pneumonia (NSIP), Usual Interstitial Pneumonia (UIP)


Author(s):  
Hari Ram Jat ◽  
Sheena Daswani ◽  
Mark Sheldon ◽  
Neel Patel

Introduction: The temporal bone is a complex anatomic structure that contains the organs of hearing and balance and has direct contact with brainstem, cerebellum and temporal lobe of brain. Radiographic assessment of temporal bone is difficult owing to complicated anatomical structure of middle and inner ear. High resolution computed tomography (HRCT) - a modification of routine CT produces images with higher contrast and a better spatial resolution. HRCT has the advantage of topographic visualization, devoid of artifacts from superimposition of structures. It provides information not only about bony outline but also soft tissue changes making it possible for the accurate assessment of pathology prior to surgical exploration regarding location, extent and complication of the disease. Material and methods: This was a cross sectional study of 50 patients who were clinically suspected of having symptoms related to the temporal bone like hearing loss, otorrhea, otalgia, tinnitus, vertigo, ear bleed, cranial nerve palsies, fever, ataxia etc were referred and subjected to HRCT of the temporal bone at Geetanjali Medical College and Hospital (Udaipur) between Nov 2017 and June 2019. Results: CSOM and Cholesteatoma were the most common diseases found by HRCT and Intra-op/Follow-up scan followed by Fractures, acoustic neuroma, Glomus tympanicum and Atretic EAC. Almost all the lesions were correctly detected by HRCT when confirmed with Intra-op/follow up findings. Conclusion: HRCT can very accurately detect Temporal bone pathology. Keywords: HRCT, CSOM, CT


2019 ◽  
Vol 9 (4) ◽  
pp. 24-27
Author(s):  
Anusmriti Pal ◽  
Manoj Kumar Yadav ◽  
Chiranjibi Pant ◽  
Bishow Kumar Shrestha

Background: Interstitial lung disease (ILD) is a heterogeneous group of diffuse parenchymal lung diseases, characterized by restrictive physiology, impaired gas exchange, pulmonary inflammation and fibrosis. Chest radiograph (CXR) may appear normal during initial course of the disease and may show few abnormalities. High resolution computed tomography (HRCT) chest is a most ac­curate non-invasive, high spatial resolution descriptive imaging modality for evaluation of lung parenchyma. It assesses presence, location, type and characterization of ILD in appropriate clinical setting. Our aim was to study radiological patterns and its distribution in CXR and HRCT chest of ILD patients. Methods: This was an observational, single centered, cross-sectional study conducted at author’s place over the period of 6 months starting from January 2018 using convenient sampling method. Data analysis was done using students t-test for comparison of means and chi-square test for proportions. Results: A total of 30 suspected or diagnosed patients of ILD were enrolled in our study and pat­terns found on CXR were correlated with that on HRCT chest. The number of findings in HRCT chest for a patient was significantly higher than CXR (Median number: 4 verses 2, P<0.001), commonest reticular opacity 50% in CXR and 56.6% HRCT. One subject had normal CXR. Conclusion: HRCT was superior to CXR in detection of all basic patterns and their distribution as­sociated with ILD as higher numbers of findings were detected by HRCT chest as compared to CXR. HRCT chest could characterize the abnormality and specify its location much more accurately.


2003 ◽  
Vol 121 (4) ◽  
pp. 167-172 ◽  
Author(s):  
Rosane Reis de Mello ◽  
Maria Virgínia Peixoto Dutra ◽  
José Roberto Ramos ◽  
Pedro Daltro ◽  
Márcia Boechat ◽  
...  

CONTEXT: Premature infant lung development may be affected by lung injuries during the first few weeks of life. Lung injuries have been associated with changes in lung mechanics. OBJECTIVE: To evaluate an association between lung mechanics and lung structural alterations in very low birth weight infants (birth weight less than 1500 g). DESIGN: A cross-sectional evaluation of pulmonary mechanics (lung compliance and lung resistance) and high resolution computed tomography of the chest at the time of discharge, in 86 very low birth weight infants born at Instituto Fernandes Figueira, a tertiary public healthcare institution in Rio de Janeiro, Brazil. Lung compliance and resistance were measured during quiet sleep. High resolution computed tomography was performed using Pro Speed-S equipment. MAIN MEASUREMENTS: Statistical analysis was performed by means of variance analysis (ANOVA/ Kruskal Wallis). The significance level was set at 0.05. RESULTS: Abnormal values for both lung compliance and lung resistance were found in 34 babies (43%), whereas 20 (23.3%) had normal values for both lung compliance and lung resistance. The mean lung compliance and lung resistance for the group were respectively 1.30 ml/cm H2O/kg and 63.7 cm H2O/l/s. Lung alterations were found via high-resolution computed tomography in 62 (72%) infants. Most infants showed more than one abnormality, and these were described as ground glass opacity, parenchymal bands, atelectasis and bubble/cyst. The mean compliance values for infants with normal (1.49 ml/cm H2O/kg) high resolution computed tomography, 1 or 2 abnormalities (1.31 ml/cm H2O/kg) and 3 or more abnormalities (1.16 ml/cm H2O/kg) were significantly different (p = 0.015). Our data were insufficient to find any association between lung resistance and the number of alterations via high-resolution computed tomography. CONCLUSION: The results show high prevalence of lung functional and tomographic abnormalities in asymptomatic very low birth weight infants at the time of discharge. They also show an association between lung morphological and functional abnormalities.


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