scholarly journals Diagnostic accuracy of perioperative electromyography in the positioning of pedicle screws in adolescent idiopathic scoliosis treatment: a cross-sectional diagnostic study

2020 ◽  
Author(s):  
Carlos Eduardo Barsotti ◽  
Bruno Moreira Gavassi ◽  
Francisco Eugenio Prado ◽  
Bernardo Nogueira Batista ◽  
Raphael de Resende Pratali ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Diagnostic Accuracy ◽  
Nerve Injury ◽  
Predictive Value ◽  
Sagittal Plane ◽  
False Negative ◽  
Pedicle Screws ◽  
Diagnostic Study ◽  
Cross Sectional

Abstract Background: To investigate electromyography (EMG) thresholds for predicting pedicle screw positioning during adolescent idiopathic scoliosis (AIS) surgery.Methods: 16 patients were included. Each screw was classified as “at risk for nerve injury” (ARNI) or “no risk for nerve injury” (NRNI) using CT and the diagnostic accuracy of EMG thresholds for predicting screw positions ARNI was investigated.Results: 226 pedicles were analyzed. In the axial plane, 204 (90.3%) screws were considered as NRNI, and 22 (9.7%), as ARNI. In the sagittal plane, 183 (81%) pedicle screws were considered as NRNI, and 43 (19%), as ARNI. We observed a significant association between EMG responses and screw positioning ARNI. A 1-mA decrease in EMG threshold corresponded to a 12% increase in the odds of screw position ARNI (OR=1.12; p<.001). The positive predictive value of EMG for diagnosing ARNI was very low, with the highest 18% corresponding to a cutoff of 25 mA, but the negative predictive value was moderate to high (78%-93%) for every cutoff.Conclusions: EMG had a poor accuracy for predicting screws ARNI but was effective for minimizing false-negative screws ARNI.

scholarly journals Diagnostic accuracy of perioperative electromyography in the positioning of pedicle screws in adolescent idiopathic scoliosis treatment: a cross-sectional diagnostic study

2020 ◽  
Author(s):  
Carlos Eduardo Barsotti ◽  
Bruno Moreira Gavassi ◽  
Francisco Eugenio Prado ◽  
Bernardo Nogueira Batista ◽  
Raphael de Resende Pratali ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Diagnostic Accuracy ◽  
Nerve Injury ◽  
Sagittal Plane ◽  
False Negative ◽  
Pedicle Screws ◽  
Axial Plane ◽  
Diagnostic Study ◽  
Cross Sectional ◽  
Curve Magnitude

Abstract Background: To investigate in the conventional techniques of the pedicle screws using triggered screw electromyography (t-EMG), considering different threshold cutoffs: 10, 15, 20 25 mA, for predicting pedicle screw positioning during surgery of the adolescent with idiopathic scoliosis (AIS). Methods: Sixteen patients (4 males, 12 females, average age 16.6 years) were included, with an average curve magnitude of 50 degrees and placement of 226 pedicle screws. Each screw was classified as “at risk for nerve injury” (ARNI) or “no risk for nerve injury” (NRNI) using CT and the diagnostic accuracy of EMG considering different threshold cutoffs (10,15, 20 and 25 mA) in the axial and Sagittal planes for predicting screw positions ARNI was investigated. Results: The EMG exam accuracy, in the axial plane, 90.3% screws were considered NRNI. In the sagittal plane, 81% pedicle screws were considered NRNI. A 1-mA decrease in the EMG threshold was associated with a 12% increase in the odds of the screw position ARNI. In the axial and sagittal planes, the ORs were 1.09 and 1.12, respectively. At every threshold cutoff evaluated, the PPV of EMG for predicting screws ARNI was very low in the different threshold cutoff (10 and 15); the highest PPV was 18% with a threshold cutoff of 25 mA. The PPV was always slightly higher for predicting screws ARNI in the sagittal plane than in the axial plane. In contrast, there was a moderate to high NPV (78%-93%) for every cutoff analyzed. Conclusions: EMG had a moderate to high accuracy for positive predicting value screws ARNI with increase threshold cutoffs of 20 and 25 mA. In addition, showed to be effective for minimizing false-negative screws ARNI in the different threshold cutoffs of the EMG in adolescent with idiopathic scoliosis (AIS).

scholarly journals Diagnostic accuracy of perioperative electromyography in the positioning of pedicle screws in adolescent idiopathic scoliosis treatment: a cross-sectional diagnostic study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Carlos Eduardo Barsotti ◽  
Bruno Moreira Gavassi ◽  
Francisco Eugenio Prado ◽  
Bernardo Nogueira Batista ◽  
Raphael de Resende Pratali ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Diagnostic Accuracy ◽  
Pedicle Screws ◽  
Diagnostic Study ◽  
Cross Sectional ◽  
Scoliosis Treatment

scholarly journals DIAGNOSTIC ACCURACY OF 99 MTC LABELLED UBIQUICIDIN (29-41) SPECT/CT FOR DIAGNOSIS OF OSTEOMYELITIS IN DIABETIC FOOT

2021 ◽  
Vol 71 (3) ◽  
pp. 1015-19
Author(s):  
Muhammad Atif ◽  
Fida Hussain ◽  
Zaigham Salim Dar ◽  
Jameela Khatoon ◽  
Saadia Ajmal ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diabetic Foot ◽  
Predictive Value ◽  
Gold Standard ◽  
Soft Tissues ◽  
Bone Biopsy ◽  
False Negative ◽  
Armed Forces ◽  
True Negative ◽  
Cross Sectional

Objective: To determine diagnostic accuracy of 99mTc labelled Ubiquicidin (29-41) SPECT/CT for detection of osteomyelitis in diabetic foot patients by taking bone biopsy as gold standard. Study Design: Cross-sectional validation study. Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, from Apr 2017 to Mar 2018. Methodology: Study assessed 122 patients of both genders, aged between 30-80 years (mean age=55.3 years), presenting with diabetic foot ulcers having suspicion of osteomyelitis, by 99mTc-Ubiquicidin (29-41) SPECT/CT followed by bone biopsy (histopathology and culture) taken as gold standard. Results: Among 122 patients [94 male (77%) and 28 female (23%)], osteomyelitis was histopathologically confirmed in 113 patients. 107 out of these patients were positive for osteomyelitis on 99mTc-UBI (29-41) SPECT/CT (true positives) while 6 were false negative. Out of 9 patients declared negative for osteomyelitis on histopathology and culture, 8 were negative on 99mTc-UBI (29-41) SPECT/CT as well (true negative) while only 1 case came out to be positive (false positive). Thus, the 99mTc-UBI (29-41) scan showed 94.6% sensitivity, 88.89% specificity, 99% positive predictive value, 57% negative predictive value with overall 94.2% diagnostic accuracy. Conclusion: 99mTc labelled Ubiquicidin (29-41) SPECT/CT scan can precisely localize infective focus, in diabetic foot osteomyelitis, with simultaneous discrimination between bone and soft tissues.

scholarly journals Positioning of pedicle screws in adolescent idiopathic scoliosis using electromyography

2015 ◽  
Vol 14 (2) ◽  
pp. 97-100
Author(s):  
Bruno Moreira Gavassi ◽  
Raphael de Rezende Pratali ◽  
Carlos Eduardo Gonçales Barsotti ◽  
Ricardo José Rodriguez Ferreira ◽  
Francisco Prado Eugenio dos Santos ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Prospective Observational Study ◽  
Sagittal Plane ◽  
Pedicle Screws ◽  
Neurological Damage ◽  
Single Institution ◽  
Ideal Position ◽  
Safe Technique

<sec><title>OBJECTIVE:</title><p> To analyze the occurrence of poor positioning of pedicle screws inserted with the aid of intraoperative electromyographic stimulation in the treatment of Adolescent Idiopathic Scoliosis (AIS).</p></sec><sec><title>METHODS:</title><p> This is a prospective observational study including all patients undergoing surgical treatment for AIS, between March and December 2013 at a single institution. All procedures were monitored by electromyography of the inserted pedicle screws. The position of the screws was evaluated by assessment of postoperative CT and classified according to the specific AIS classification system.</p></sec><sec><title>RESULTS:</title><p> Sixteen patients were included in the study, totalizing 281 instrumented pedicles (17.5 per patient). No patient had any neurological deficit or complaint after surgery. In the axial plane, 195 screws were found in ideal position (69.4%) while in the sagittal plane, 226 screws were found in ideal position (80.4%). Considering both the axial and the sagittal planes, it was observed that 59.1% (166/281) of the screws did not violate any cortical wall.</p></sec><sec><title>CONCLUSION:</title><p> The use of pedicle screws proved to be a safe technique without causing neurological damage in AIS surgeries, even with the occurrence of poor positioning of some implants.</p></sec>

Diagnostic Accuracy of Ultrasonography for Detection of AT by Taking Surgical Findings as Gold Standard

2021 ◽  
Vol 15 (11) ◽  
pp. 3093-3095
Author(s):  
Iqra Rafique ◽  
Anam Manzoor ◽  
Sana Naseer
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
False Negative ◽  
Achilles Tendinopathy ◽  
Military Hospital ◽  
True Negative ◽  
Cross Sectional ◽  
Female Ratio ◽  
Standard Design

Objective: To assess the diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy by taking surgical findings as gold standard. Design of the Study: It was a descriptive cross-sectional study. Study Settings: This study was carried out at Department Of Diagnostic Radiology And Diagnostic Imaging Combined Military Hospital, Lahore from 23rd December 2017 to 22nd June 2018. Material and Methods: A total of 70 patients of age 20-70 years, of either gender presenting with severe pain and swelling in area of Achilles tendon were included. Patients with heel pain having concurrent heel ulcer, eczematous changes or calcaneal fractures, muscular dystrophy and previous surgery were excluded. All the patients were then underwent ultrasonography and findings were noted for presence or absence of Achilles tendinopathy. Each Ultrasonographic finding were compared with surgical findings. Results of the Study: Mean age was 41.24 ± 10.34 years. Out of these 70 patients, 46 (65.71%) were male and 24 (34.29%) were females with male to female ratio of 1.9:1. In USG positive patients, 40 (True Positive) had Achilles tendinopathy and 04 (False Positive) had no Achilles tendinopathy on surgical findings. Among, 26 USG negative patients, 03 (False Negative) had Achilles tendinopathy on surgical findings whereas 23 (True Negative) had no Achilles tendinopathy on surgical findings. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy by taking surgical findings as gold standard was 93.02%, 85.19%, 90.91%, 88.46% and 90.0% respectively. Conclusion: This study concluded that diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy is quite high. Keywords: Achilles tendinopathy, ultrasonography, sensitivity.

Diagnostic Accuracy of Sonomammography in Diagnosis of BIRADS 4 Suspicious Breast Lesions Keeping Histopathology as Gold Standard

2021 ◽  
Vol 15 (10) ◽  
pp. 2772-2775
Author(s):  
Anam Manzoor ◽  
Iqra Rafique ◽  
Sana Naseer
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
False Negative ◽  
Military Hospital ◽  
Breast Lesions ◽  
True Negative ◽  
Cross Sectional ◽  
Standard Design ◽  
Malignant Breast

Objective: To assess the diagnostic accuracy of sonomammography in diagnosis of BIRADS ≥4 suspicious breast lesions taking histopathology as gold standard. Design of the Study: It was a descriptive cross-sectional study. Study Settings: This study was carried out at Department Of Diagnostic Radiology And Diagnostic Imaging Combined Military Hospital, Lahore from January 2017 to June 2017. Material and Methods: A total of 190 patients of age 30-70 years, presenting with palpable breast lesions with BIRAD ≥4 undergoing biopsy under local anesthesia were included. Patients with already diagnosed with breast cancer and recurrent breast lesion were excluded. Then all patients were undergone USG by using a high-resolution unit (PLM703AT) with a linear array probe centered at 7, 5 MHz, along with mammography using mamomet 3000 NOVA SIEMENS, General Electric Medical Systems, Milwaukee. Patients were labeled as positive or negative. Sonomammography findings were correlated with histopathological findings. Results of the Study: In 117 sonomammography positive patients, 107 (True Positive) had malignant breast lesions and 08 (False Positive) had benign on histopathology findings. Among, 75 sonomammography negative patients, 06 (False Negative) had malignant breast lesions on histopathology whereas 69 (True Negative) had benign lesions on histopathology. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of sonomammography in diagnosis of BIRADS ≥4 suspicious breast lesions taking histopathology as gold standard was 94.69%, 89.61%, 93.04%, 92.0% and 92.63% respectively. Conclusion: This study concluded that diagnostic accuracy of sonomammography in diagnosis of BIRADS ≥4 suspicious breast lesions is quite high. Keywords: Breast lesions, malignant, sonomammography, sensitivity.

scholarly journals Diagnostic Accuracy of Ultrasonography in Diagnosing Morbidly Adherent Placenta, Taking Intra-Operative Findings as Gold Standard

Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Anum Yousaf ◽  
Misbah Durrani ◽  
Khoala Riaz ◽  
Ume Kalsoom ◽  
Hassan Parvez
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Color Doppler ◽  
False Negative ◽  
True Negative ◽  
Cross Sectional ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Operative Findings

Objective: Various imaging modalities can be employed for the placenta accreta diagnosis like USG and MRI, however, their exact diagnostic accuracy is yet to be established. This study was conducted for determining the accuracy of ultrasonography in diagnosing morbidly adherent placenta in women with a previous scar, taking the per-operative findings as gold standard. Methods: This descriptive cross-sectional study was carried out at department of Radiology, Benazir Bhutto Hospital, Rawalpindi from 6th January 2019 to 5th July 2019. Using non-probability purposive sampling 118 pregnant women with single pregnancy of age 18-40 years were included. Both grey scale and color doppler findings of ultrasound were employed for ascertaining presence or absence of morbidly adherent placenta. Per-operative findings of all patients who underwent cesarean section afterwards in their respective wards were registered. The findings of USG were then compared with the per-operative observations. Results: Among patients in whom USG findings were of morbidly adherent placenta, 60 were true positive while 05 were false positive, whereas, in the patients with no evidence of morbidly adherent placenta on USG, 03 were false negative while 50 were true negative. The sensitivity, specificity, positive predictive value negative predictive value and diagnostic accuracy of USG in diagnosing morbidly adherent placenta in previous scar women, taking per -operative findings as gold standard was 95.24%, 90.91%, 92.31%, 94.34% and 93.22% respectively. Conclusion: It can be inferred from our study that USG is a very sensitive and accurate non-invasive imaging technique for the diagnosis of morbidly adherent placenta. Keywords: morbidly adherent placenta, ultrasonography, sensitivity. How to cite: Yousaf A., Durrani M., Riaz K., Kalsoom U., Parvez H. Diagnostic accuracy of ultrasonography in diagnosing morbidly adherent placenta, taking intra-operative findings as gold standard. Esculapio. 2021; 17(01): 71-74

scholarly journals Diagnostic accuracy of TI-RADS classification in differentiating benign and malignant thyroid nodules-a study from Southern Punjab, Pakistan

BioMedica ◽  
2021 ◽  
Vol 37 (3) ◽  
pp. 1-14
Author(s):  
Sumera Nighat ◽  
Mahwish Zahra ◽  
Azhar Mahmood Javed ◽  
Shabbir Ahmad ◽  
Sadia Anwar ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Thyroid Nodules ◽  
Local Population ◽  
False Negative ◽  
Imaging Evaluation ◽  
True Negative ◽  
Cross Sectional ◽  
Study Results

<p><strong>Background and Objective:</strong> Thyroid imaging reporting and data system (TI-RADS) is developed to determine the risk of malignancy in patients with thyroid nodules. The aim of this study was to determine the diagnostic accuracy of TI-RADS classification for diagnosing malignant thyroid nodules taking Fine needle aspiration cytology (FNAC) as a gold standard in the local population.</p> <p><strong>Methods:</strong> In this cross-sectional validation study, 201 patients presenting with thyroid nodules at the Department of Radiology, Bakhtawar Amin Hospital Multan, Pakistan from July 2020 to December 2020 were included. In all patients, thyroid nodules were evaluated on grey scale (B-mode) modality. TI-RADS score was calculated for each patient. Patients with TI-RADS score 4 and 5 were labelled as having malignant nodules. After that FNAC samples were taken and sent for histopathologic evaluation of thyroid nodules. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TI-RADS taking FNAC as a gold standard were determined.</p> <p><strong>Results:</strong> The mean age of the patients was 47.8 &plusmn; 4.5 years; there were 129 (67.2%) women and 72 (35.82%) men. There were 42 patients who tested true positive and 36 patients tested false positive and 12 patients were false negative and 111 patients true negative. The TIRADS sensitivity was 77.8%, specificity was 75.5%, PPV was 53.8%, and NPV 90.2%. the diagnostic accuracy was 76.1%.</p> <p><strong>Conclusion: </strong>Differentiating benign thyroid nodules from malignant using the TI-RADS score has a high diagnostic accuracy. Our study results support the TIRADS as a first-line imaging evaluation for diagnosis of thyroid malignancy.</p>

Thoracic sagittal plane variations between patients with thoracic adolescent idiopathic scoliosis and healthy adolescents

2016 ◽  
Vol 25 (10) ◽  
pp. 3095-3103 ◽  
Author(s):  
Javier Pizones ◽  
Alberto Núñez-Medina ◽  
Felisa Sánchez-Mariscal ◽  
Lorenzo Zúñiga ◽  
Enrique Izquierdo
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Sagittal Plane

Diagnostic Accuracy of HRCT Chest in Detection of Covid-19 Infection Taking PCR as Gold Standard

2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Cross Sectional Study ◽  
Radiology Department ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Head Of Department

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

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