scholarly journals Role of MRI in the Evaluation of Adnexal Masses - A Prospective Study

2021 ◽  
Vol 8 (15) ◽  
pp. 956-962
Author(s):  
Aswini Jyothi Jayam Subramanyam ◽  
Surya Prakash Cheedalla ◽  
Vanaja Bulkapuram ◽  
Veena Madireddy ◽  
Vijaya Kumari
Keyword(s):  
Predictive Value ◽  
Treatment Algorithm ◽  
Pelvic Mass ◽  
Maternity Hospital ◽  
Mri Findings ◽  
Accurate Identification ◽  
Cross Sectional ◽  
Adnexal Masses ◽  
Pelvic Malignancies

BACKGROUND Among all the disorders of female reproductive system, adnexal masses are one of the most common disorders. The main purpose of the study was to evaluate an adnexal mass and to differentiate the mass as benign or malignant and facilitate selection of appropriate treatment algorithm. For few benign lesions, radiological follow-up is very suitable for further management and additional follow-up may not be useful when an imaging abnormality is not found. METHODS Our study was conducted in Osmania General Hospital and its allied hospital named Government Maternity Hospital, Hyderabad, on about 150 patients. This is an institution-based, multicentric, cross-sectional, prospective, analytical study. All clinically suspected female patients with adnexal masses referred to the Department of Radiodiagnosis were evaluated. These patients were first subjected to ultrasonography, followed by magnetic resonance imaging (MRI) (plain and contrast wherever required). MRI findings were compared with ultrasonography. These findings were compared with operative findings and histopathological findings, wherever performed. RESULTS In the present study, females in the age group of 21 – 40 years showed majority of pelvic lesions - 81 (54 %). Most of the pelvic masses were arising from the ovary - 102 (68 %). Majority of the adnexal lesions on MRI were benign in nature - 132 (88 %). MRI showed a sensitivity of 100 %, specificity of 97.7 %, and a positive predictive value of 83 %, & a negative predictive value of 100 %. CONCLUSIONS In practice, ultrasonography (USG) is the primary modality for diagnosing the pelvic mass. MRI is superior to ultrasound and can be used as problem solving technique in the assessment of pelvic mass. The multiplanar imaging capability allows accurate identification of origin of mass and characterisation of mass. This is helpful to the preoperative planning of sonographically detected mass and avoids surgery in possible cases. MRI is the technique of choice for staging, treatment planning and post treatment follow-up of pelvic malignancies. KEYWORDS MRI, USG, Adnexal Masses, Ovarian Masses, Board Ligament Lesions, Fallopian Tube Lesions, Cysts

scholarly journals Effectiveness Of Transient Evoked Otoacoustic Emission (TEOAE) Test For Neonatal Auditory Screening

2018 ◽  
Vol 08 (02) ◽  
pp. 77-81
Author(s):  
Shanila Feroz ◽  
Iqbal Hussain Udaipurwala ◽  
Danish Muhammad Khan ◽  
Fatima Iqbal Hussain
Keyword(s):  
Hearing Loss ◽  
Predictive Value ◽  
False Negative ◽  
Otoacoustic Emission ◽  
Normal Hearing ◽  
Speech Development ◽  
True Negative ◽  
Cross Sectional ◽  
Transient Evoked Otoacoustic Emission

Objective: The purpose of this study is to assess the efficacy of Transient Evoked Otoacoustic Emission (TEOAE) as screening test for auditory function in neonates. Study Design: A cross-sectional study Place and Duration of Study: This study was conducted at United Medical and Dental College, Creek General Hospital, Karachi, from July 2106 to May 2017. A total number of 120 newborn babies were screened for hearing loss before discharge from hospital but 20 were lost for follow up and 100 cases were included in this study. Method: TEOAE was done in all neonates born during this period at 3rd day after birth. Those who were found to have hearing loss, TEOAE was repeated at the end of 1st week and again in 6th week after birth. BERA was done in those cases who showed hearing loss on TEOAE on all three occasions. All the 100 cases were followed up regularly for more than one year for appearance of any sign or symptom related with hearing loss or speech development failure. Result: Out of 100 cases included in this study, 96 were found to have no hearing loss on TEOAE and 1 on BERA test. Remaining three cases were found to have hearing loss on both TEOAE and BERA test. True negative cases where no hearing loss was found on TEOAE and subsequent follow up were 96. True positive cases were 3 where hearing loss was found on TEOAE and BERA and also on subsequent follow-up. False positive case was 1, where hearing loss was detected on TEOAE but BERA showed normal hearing and subsequent follow-up also showed normal hearing and false negative result was not detected in any case. Sensitivity of TEOAE was found to be 100%, specificity is 98.9%, accuracy is 99%, positive predictive value is 75% and negative predictive value is 100% in this study. Conclusion: TEOAE was found to be a cost-effective and practicable method of recognizing congenital hearing loss. It should be done in all newborns as routine screening for hearing loss

scholarly journals Patient-reported outcomes after surgical and non-surgical treatment of proximal hamstring avulsions in middle-aged patients

2019 ◽  
Vol 5 (1) ◽  
pp. e000511 ◽  
Author(s):  
Elsa Pihl ◽  
Olof Skoldenberg ◽  
Hans Nasell ◽  
Sven Jonhagen ◽  
Paula Kelly Pettersson ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Algorithm ◽  
Hamstring Injury ◽  
Middle Aged ◽  
Mri Findings ◽  
Aged Patients ◽  
Patient Reported ◽  
Proximal Hamstring ◽  
Non Surgical Treatment

ObjectivesIn the literature on proximal hamstring avulsions, only two studies report the outcomes of non-surgically treated patients. Our objective was to compare subjective recovery after surgical and non-surgical treatment of proximal hamstring avulsions in a middle-aged cohort.MethodsWe included 47 patients (33 surgically and 14 non-surgically treated) with a mean (SD) age of 51 (±9) years in a retrospective cohort study. Follow-up time mean (SD) of 3.9 (±1.4) years. The outcome variables were the Lower Extremity Functional Scale (LEFS) and questions from the Proximal Hamstring Injury Questionnaire. Outcome variables were adjusted in regression models for gender, age, American Society of Anestesiologits (ASA) classification and MRI findings at diagnosis.ResultsThe baseline characteristics showed no differences except for the MRI result, in which the surgically treated group had a larger proportion of tendons retracted ≥ 2 cm. The mean LEFS score was 74 (SD±12) in the surgically treated cohort and 72 (SD±16) in the non-surgically treated cohort. This was also true after adjusting for confounders. The only difference in outcome at follow-up was the total hours performing physical activity per week, p=0.02; surgically treated patients reported 2.5 hours or more (5.2 vs 2.7).ConclusionThis study on middle-aged patients with proximal hamstring avulsions was unable to identify any difference in patient-reported outcome measures between surgically and non-surgically treated patients. The vast majority of patients treated surgically had complete proximal hamstring avulsions with ≥ 2 cm of retraction. We conclude that to obtain an evidence-based treatment algorithm for proximal hamstring avulsions studies of higher scientific level are needed.

scholarly journals Simple vs ugly adnexal lesions: is ultrasonography alone good enough?

2019 ◽  
Vol 7 (8) ◽  
pp. 3020
Author(s):  
Rahul Dev Chauhan ◽  
Yashvir Mathur
Keyword(s):  
Histopathological Examination ◽  
Imaging Modality ◽  
Cross Sectional Study ◽  
Colour Doppler ◽  
Benign Lesions ◽  
Cross Sectional ◽  
Adnexal Masses ◽  
Cross Sectional Imaging ◽  
Ovarian Masses

Background: Ultrasound (USG) is easily available and effective imaging modality for adnexal lesions. A simple looking lesion on ultrasound is usually benign and an ugly looking adnexal lesion is either benign or malignant. This study aims to evaluate the varied appearance of simple and ugly benign adnexal lesions on USG and to find out any additional role of colour Doppler in such suspected benign lesions. The confirmation of diagnosis was done either by follow up appearance of lesions on USG or by histopathological evaluation.Methods: A total of 55 consecutive female patients with age between 18 to 50 years were enrolled in this prospective cross sectional study. USG and colour Doppler for all the lesions were done. The patients found to have malignant lesions on histopathological examination, were later excluded from the analysis. Follow up USG was done for all the cases. Those cases wherein there was no resolution of lesions even after 08 weeks, were given an option to undergo laparoscopy as next management step.Results: Out of 50 benign adnexal masses, 88% masses were ovarian in origin and 12% were tubal masses. Ovarian masses included hemorrhagic cysts, endometriosis, simple cysts, serous cystadenomas and ovarian dermoid. All extra-ovarian masses were hydrosalpinx. Colour Doppler did not add any additional finding. Some of the patients underwent diagnostic laparoscopy followed by excision of masses in majority of them.Conclusions: Benign adnexal lesions can have varied appearance ranging from simple to ugly on USG. Ultrasonographic features of benign lesions on USG can be appreciated very well even without further use of colour Doppler or cross sectional imaging. Follow up USG remains key modality for benign adnexal masses in absence of MRI.

scholarly journals SNIPER: A Novel Assay for Human Papillomavirus Testing Among Women in Guizhou, China

2010 ◽  
Vol 20 (6) ◽  
pp. 1006-1010 ◽  
Author(s):  
Suzanne E. Belinson ◽  
Na Wulan ◽  
Ruizhen Li ◽  
Wei Zhang ◽  
Xuan Rong ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Predictive Value ◽  
Polymerase Chain Reaction Amplification ◽  
Intraepithelial Neoplasia ◽  
Guizhou Province ◽  
Papanicolaou Test ◽  
Cross Sectional ◽  
Hpv Dna ◽  
Hpv Status

Objective:Clinically validate the SNIPER human papillomavirus (HPV) DNA assay for the detection of cervical intraepithelial neoplasia (CIN)2 or higher and CIN2 or higher in a prospective cross-sectional screening study in Guizhou Province, China.Methods:Between March and April, 2008, 1000 nonpregnant women aged 30 or older were recruited in Guizhou Province, China. Women positive by SNIPER or cytological examination were requested to return for follow-up. A biopsy of all colposcopically detected abnormalities was performed by quadrant. In normal quadrants, biopsies were obtained at the squamocolumnar junction (2-, 4-, 8-, and 10-o'clock positions depending on the quadrant). Samples were placed in 2 mL of saline solution and maintained between 2°C and 30°C for up to 1 week. One milliliter of this suspension was then prepared and tested. For polymerase chain reaction amplification, a pool of HPV primers was designed to amplify HPV DNA from 13 high-risk-HPV genotypes (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68). Test characteristics were calculated according to standard definitions.Results:One thousand women were screened; 175 tested HPV positive, 36 women tested negative but had positive Papanicolaou test results. All but 21 (90%) returned for follow-up. Median age and proportions having CIN2 or higher and CIN3 or higher differed by HPV status. Twenty-five women had CIN2 or higher and 16 had CIN3 or higher. The SNIPER assay was 93.3% and 94% sensitive and 86% and 85% specific for the detection of CIN2 or higher and CIN3 or higher, respectively. The positive predictive value was 17.4 % and 9.9% for CIN2 or higher and CIN3 or higher, respectively. Negative predictive value approached 100% for CIN2 or higher and CIN3 or higher.Conclusion:The SNIPER assay is functionally competitive and in terms of cost holds an advantage over Hybrid Capture 2 in a Chinese healthcare market, and potentially others, around the world.

scholarly journals TO EVALUATE THE ROLE OF MAGNETIC RESONANCE IMAGING (MRI) IN PELVIC MASSES IN FEMALE PATIENTS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
G. Santhosh Kumar ◽  
Sawleha Arshi Khan ◽  
Disha Shah
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Endometrial Carcinoma ◽  
Pelvic Mass ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Accurate Identification ◽  
Female Patients ◽  
Pelvic Masses ◽  
Operative Findings

Background & Method: Study was conducted at Mediciti Institute of Medical Sciences, Medchal, Telangana number of cases studied 30. All clinically suspected female patients with pelvic masses referred to the Department of Radio-diagnosis were evaluated. These patients were first subjected to Ultrasonography followed by MRI (plain and contrast where ever required). MRI findings were compared with that of Ultrasonography. These findings were compared with that of operative findings and histopathological findings wherever performed. Result: Majority of uterocervical lesions on MRI were malignant in nature. One case of endometrial polyp in usg, diagnosed as stage Ib endometrial carcinoma, and cervical fibroid was diagnosed as cervical carcinoma stage II, on MRI 2cases of cervical and 2 cases of endometrial carcinoma. Conclusion: In practice USG is the primary modality for diagnosing the pelvic mass. MRI is superior to ultrasound and can be used as problem solving tool in the assessment of pelvic mass. The multiplanar imaging capability allows accurate identification of origin of mass, characterization of mass(solid, haemorrhagic, fatty and fibrous contents).This may obviate surgery or significantly contribute to the preoperative planning of pelvic  mass Keywords: Magnetic Resonance Imaging, pelvic & female. Study Designed: Observational Study

The Role of Diffusion-weighted Magnetic Resonance Imaging in the Evaluation of Anterior Cruciate and Posterior Cruciate Ligament Tears

2019 ◽  
Vol 1 ◽  
pp. 97-100
Author(s):  
Vijinder Arora ◽  
Sonali Malik ◽  
Kunwarpal Singh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Conventional Mri ◽  
Anterior Cruciate

Objective: The objective of our study was to determine the role of diffusion-weighted (DW) magnetic resonance imaging (MRI) in diagnosing and differentiating between complete and partial anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears and to compare it with conventional MRI sequences. Materials and Methods: We conducted a prospective study for a period of 2 years from October 2017 to October 2019 on 30 patients with clinically suspected ACL/PCL injuries of the knee. MRI of the knee joint was performed using conventional, and DW sequences and the findings on both the sequences were assessed independently and compared with the intraoperative or follow-up MRI findings. Results: As per operative and follow-up MRI findings, the sensitivity and specificity of conventional MRI were 60% and 33.33% with a positive and negative predictive value of 47.37% and 45.45%, respectively. On the other hand, the sensitivity and specificity of DW MRI were 70.00% and 33.33% with a positive and negative predictive value of 51.22% and 52.13%, respectively. P = 0.417 was statistically not significant. Conclusion: According to our study, adding DW sequence to conventional MR sequences yielded comparable results in diagnosis and differentiation between complete and partial ACL and PCL tears.

scholarly journals Comparison of Natural Language Processing and Manual Coding for the Identification of Cross-Sectional Imaging Reports Suspicious for Lung Cancer

2018 ◽  
pp. 1-7 ◽  
Author(s):  
Roxanne Wadia ◽  
Kathleen Akgun ◽  
Cynthia Brandt ◽  
Brenda T. Fenton ◽  
Woody Levin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Natural Language Processing ◽  
Natural Language ◽  
Negative Predictive Value ◽  
Language Processing ◽  
Predictive Value ◽  
Cross Sectional ◽  
Predictive Values ◽  
Clinical Text

Purpose To compare the accuracy and reliability of a natural language processing (NLP) algorithm with manual coding by radiologists, and the combination of the two methods, for the identification of patients whose computed tomography (CT) reports raised the concern for lung cancer. Methods An NLP algorithm was developed using Clinical Text Analysis and Knowledge Extraction System (cTAKES) with the Yale cTAKES Extensions and trained to differentiate between language indicating benign lesions and lesions concerning for lung cancer. A random sample of 450 chest CT reports performed at Veterans Affairs Connecticut Healthcare System between January 2014 and July 2015 was selected. A reference standard was created by the manual review of reports to determine if the text stated that follow-up was needed for concern for cancer. The NLP algorithm was applied to all reports and compared with case identification using the manual coding by the radiologists. Results A total of 450 reports representing 428 patients were analyzed. NLP had higher sensitivity and lower specificity than manual coding (77.3% v 51.5% and 72.5% v 82.5%, respectively). NLP and manual coding had similar positive predictive values (88.4% v 88.9%), and NLP had a higher negative predictive value than manual coding (54% v 38.5%). When NLP and manual coding were combined, sensitivity increased to 92.3%, with a decrease in specificity to 62.85%. Combined NLP and manual coding had a positive predictive value of 87.0% and a negative predictive value of 75.2%. Conclusion Our NLP algorithm was more sensitive than manual coding of CT chest reports for the identification of patients who required follow-up for suspicion of lung cancer. The combination of NLP and manual coding is a sensitive way to identify patients who need further workup for lung cancer.

Contrast-enhanced ultrasound (CEUS) reliably rules out neoplasm in developmental renal pseudotumor

2020 ◽  
pp. 028418512093929
Author(s):  
Paul Spiesecke ◽  
Thomas Fischer ◽  
Andreas Maxeiner ◽  
Bernd Hamm ◽  
Markus H Lerchbaumer
Keyword(s):  
Predictive Value ◽  
Fast Method ◽  
Contrast Enhanced Ultrasound ◽  
Cross Sectional ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Renal Pseudotumor ◽  
Sectional Imaging ◽  
Rule Out

Background Renal pseudotumors appear as benign cortical hypertrophies and are typically assessed by contrast-enhanced computed tomography or magnetic resonance imaging to rule out malignancy. Purpose To investigate whether contrast-enhanced ultrasound (CEUS) can rule out renal neoplasm and thus potentially reduce cross-sectional imaging and further follow-up in these patients. Material and Methods Thirty-two patients with presumption of developmental renal pseudotumor on CEUS between June 2011 and July 2019 were retrospectively analyzed. All patients were examined with a standardized renal US protocol including B-mode, color-coded duplex sonography (CCDS), and CEUS by an experienced radiologist (EFSUMB level 3). Images were retrospectively interpreted in consensus by two highly experienced radiologists. Histopathological reports, cross-sectional imaging findings, and clinical course (treatment response, long-term imaging follow-up) were defined as standard of reference. Results CEUS correctly identified 8/9 neoplastic lesions and missed one oncocytoma within the 32 included patients. Irregular vessel structure (88.9% vs. 13.0%, P = 0.007) and hyperenhancement (66.6% vs. 17.4%, P = 0.031) on CEUS were more common in neoplasm compared to developmental pseudotumors reaching statistical significance. Compared with the standard of reference, CEUS had 89% sensitivity (95% confidence interval [CI] 57–98), 96% specificity (95% CI 80–99), a positive predictive value of 89% (95% CI 57–98), and a negative predictive value of 96% (95% CI 79–99) for ruling out renal malignancy in developmental pseudotumors. Conclusion CEUS is a safe and fast method to rule out neoplasm in the diagnostic work-up of renal pseudotumors. In conjunction with B-mode and CCDS, CEUS has the potential to reduce further (invasive) diagnostic procedures.

Association between MRI parameters and the MS severity scale: a 12 year follow-up study

2009 ◽  
Vol 15 (5) ◽  
pp. 632-637 ◽  
Author(s):  
A Minneboo ◽  
BMJ Uitdehaag ◽  
P Jongen ◽  
H Vrenken ◽  
DL Knol ◽  
...  
Keyword(s):  
Disease Severity ◽  
Predictive Value ◽  
Brain Mri ◽  
Multiple Regression Model ◽  
Lesion Load ◽  
Term Outcome ◽  
Cross Sectional ◽  
Relapsing Remitting ◽  
Magnetic Resonance Imaging Mri

Background Several magnetic resonance imaging (MRI) parameters are known to be associated with short-term outcome in multiple sclerosis (MS) patients. MS-related disability typically progresses over decades, stressing the need for longer follow-up studies. Until now, these studies are relatively sparse and, therefore, the predictive value of MRI parameters for clinical disability remains largely unknown. Objective To assess the predictive value of brain MRI parameters, which are obtained during the first 3.3 years of the study for overall disease severity as measured by the MS Severity Score (MSSS) after 12.2 years follow-up. Methods Forty-six MS patients were included in the study. MRI parameters included both lesion loads and atrophy measures. Average and change parameters were calculated for MRI parameters and subsequently used as independent variables in regression models, while MSSS was the dependent variable. Results Follow-up (FU) was obtained in 43/46 patients (94%) and median expanded disability status scale (EDSS) score increased significantly from 2.5 to 4.0. At last FU median MSSS was 4.3 (range 2.2–6.9). In univariate analyses, both change and cross-sectional T1-hypointense lesion load and ventricular atrophy measures were associated with MSSS. A multiple regression model included the change parameter of hypointense T1-lesion load (BHLL). This model explained 20% of variance in MSSS, which increased to 34% when type of disease (relapsing remitting or secondary progressive), age, and sex were entered additionally. Conclusion MRI measures of axonal loss are associated with higher overall disease severity in MS patients.

scholarly journals Role of risk of malignancy index for evaluation and preoperative detection of pelvic malignancies compared with pathological diagnosis

2020 ◽  
Vol 9 (9) ◽  
pp. 3611
Author(s):  
Beenish Yousseff ◽  
Mariya Amin Qurieshi ◽  
Nadiya Yousseff
Keyword(s):  
Predictive Value ◽  
Menopausal Status ◽  
Histopathological Diagnosis ◽  
Ovarian Malignancy ◽  
Cross Sectional ◽  
Jammu And Kashmir ◽  
Pelvic Malignancies ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Ultrasound Score

Background: Risk of malignancy index (RMI) is widely employed in the developed world in predicting malignant pelvic masses. The present study designed to confirm the effectiveness of the RMI to identify cases with high potential of ovarian malignancy, among patients with an adnexal mass.Methods: This was a cross-sectional study was conducted over a period of two years in a government run tertiary healthcare centre of Srinagar, Kashmir, Jammu and Kashmir, India. Study included 72 patients who underwent surgery due to adnexal mass and were evaluated for ovarian malignancy by comparing RMI with histopathological diagnosis. Data collected included demographic characteristics, ultrasound findings, menopausal status, CA125 levels, and histopathological diagnosis. For each patient, RMI was calculated as per the standard formula.Results: Analysis revealed ultrasound score had the highest sensitivity of 72.7%, while an RMI score ≥250 had the highest specificity of 88.5%. The latter also had the highest positive predictive value of 50%, while negative predictive value was highest for an ultrasound score of 3 (94%). The cut off points based on ROC analysis demonstrates significant predictive ability for ovarian cancer for both RMI and CA125 with AUC to the tune of 82.9% and 80.1% respectively.Conclusions: RMI is a simple score system which can be applied directly into clinical practice and might be of value in pre-operative assessment, and hence selecting patients who need surgical team including gynecologic oncologists.

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