Diagnostic Performance of Standard and Inverted Grey-Scale CXR in Detection of Lung Lesions in COVID-19 Patients: A Single Institute Study in the Region of Abu Dhabi

2021 ◽  
Vol 02 ◽  
Author(s):  
Abeer A. Al Helali ◽  
Mohamed A. Kukkady ◽  
Ghufran A. Saeed ◽  
Tamer I. Elholiby ◽  
Rabab A. Al Mansoori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Performance ◽  
Tertiary Care ◽  
Chest Radiographs ◽  
Diagnostic Tools ◽  
Lung Lesions ◽  
Healthcare Facilities ◽  
Grey Scale ◽  
Ct Findings ◽  
Significant Difference

Purpose: This study aimed at evaluating the diagnostic performance of standard greyscale and inverted greyscale Chest X-ray (CXR) using Computed Tomography (CT) scan as a gold standard. Methods: In this retrospective study, electronic medical records of 120 patients who had valid CXR and High-resolution CT (HRCT) within less than 24 hours after having a positive COVID-19 RT-PCR test during the period from May 19th to May 23rd, 2020, in a single tertiary care center were reviewed. PA chest radiographs were presented on 2 occasions to 5 radiologists to evaluate the role and appropriateness of standard greyscale and inverted greyscale chest radiographs (CXR) when images are viewed on high-specification viewing systems using a primary display monitor and compared to computed tomography (CT) findings for screening and management of suspected or confirmed COVID-19 patients. Results: Ninety-six (80%) patients had positive CT findings, 81 (67.5%) had positive grey scale CXR lesions, and 25 (20.8%) had better detection in the inverted grey scale CXR. The CXR sensitivity for COVID-19 pneumonia was 93.8% (95% CI (86.2% - 98.0%) and the specificity was 48.7% (95% CI (32.4% - 65.2%). The CXR sensitivity of detecting lung lesions was slightly higher in male (95.1% (95% CI (86.3% - 99.0%)) than female (90.0% (95% CI (68.3% - 98.8%)), while the specificity was 48.0% (95% CI (27.8% - 68.7%) and 50.0% (95% CI (23.0% - 77.0%) in males and females, respectively. However, no significant difference was detected in ROC area between men and women. Conclusion: The sensitivity of detecting lung lesions of CXR was relatively high, particularly in men. The results of the study support the idea of considering conventional radiographs as an important diagnostic tool in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans. CXR shows high sensitivity for detecting lung lesions in HRCT confirmed COVID-19 patients. Better detection of lesions was noted in the inverted greyscale CXR in 20.8% of cases, with positive findings in standard greyscale CXR. Conventional radiographs can be used as diagnostic tools in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans.

scholarly journals Diagnostic performance of standard and inverted grey-scale CXR in detection of lung lesions in COVID-19 patients. A single institution study in the region of Abu Dhabi

2021 ◽  
Author(s):  
Abeer Ahmed AlHelali ◽  
Mohamed Ashfaque Kukkady ◽  
Ghufran Aref Saeed ◽  
Tamer Ibrahim Elholiby ◽  
Rabab Abdulrahman Al Mansoori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Performance ◽  
Chest Radiographs ◽  
Diagnostic Tools ◽  
List Type ◽  
Lung Lesions ◽  
Healthcare Facilities ◽  
Grey Scale ◽  
Ct Findings ◽  
Significant Difference

AbstractPurposeTo evaluate diagnostic performance of greyscale and inverted greyscale Chest X-ray (CXR) using Computed Tomography (CT) scan as a gold standard.MethodsIn this retrospective study, electronic medical records of 120 patients who had valid CXR and High-resolution CT (HRCT) within less than 24 hours after having a positive COVID-19 RT-PCR test during the period from May 19 th to May 23 rd 2020 in a single tertiary care center were reviewed.PA chest radiographs were presented on 2 occasions to 5 radiologists to evaluate the role and appropriateness of greyscale and inverted greyscale chest radiographs (CXR). The images were viewed on high-specification viewing systems using a primary display monitors and compared it to computed tomography (CT) findings for screening and management of suspected or confirmed COVID-19 patients.ResultsNinety-six (80%) patients had positive CT findings, 81 (67.5%) had positive grey scale CXR lesions, and 25 (20.8%) had better detection in the inverted grey scale CXR. The CXR sensitivity for COVID-19 pneumonia was 93.8% (95% CI (86.2% - 98.0%) and the specificity was 48.7% (95% CI (32.4% - 65.2%). The CXR sensitivity of detection of lung lesions was slightly higher in male (95.1% (95% CI (86.3% - 99.0%)) than female (90.0% (95% CI (68.3% - 98.8%)), while the specificity was 48.0% (95% CI (27.8% - 68.7%) and 50.0% (95% CI (23.0% - 77.0%) in males and females, respectively. However, no significant difference was detected in ROC area between men and women.ConclusionsThe sensitivity of detection of lung lesions of CXR was relatively high, particularly in men. The results of the study support the idea of considering conventional radiographs as an important diagnostic tool in suspected COVID-19 patients especially in healthcare facilities where there is no access to HRCT scans.HighlightsCXR shows high sensitivity for detecting lung lesions in HRCT confirmed COVID-19 patients.Better detection of lesions was noted in the inverted grey scale CXR in (20.8%) of cases with positive findings in standard greyscale CXR.Conventional radiographs can be used as diagnostic tools in suspected COVID-19 patients especially in healthcare facilities where there is no access to HRCT scans.

scholarly journals Coagulopathy-related soft tissue hematoma: a comparison between computed tomography findings and clinical severity

2020 ◽  
Vol 9 (5) ◽  
pp. 205846012092326
Author(s):  
Manabu Nakayama ◽  
Kenichi Kato ◽  
Kunihiro Yoshioka ◽  
Hirotaka Sato
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Anticoagulant Therapy ◽  
Vital Signs ◽  
Coagulation Factors ◽  
Clinical Severity ◽  
Fluid Level ◽  
Ct Findings ◽  
Significant Difference ◽  
The Relationship

Background Despite increases in the incidence of coagulopathy-related soft-tissue hematoma (CRSH), the relationship between computed tomography (CT) features and clinical severity remains unclear. Purpose To retrospectively evaluate the correlation between CT findings and clinical outcomes in CRSH. Material and Methods We retrospectively reviewed data of patients diagnosed with CRSH between March 2011 and March 2018. CRSH was morphologically classified according to the presence or absence of the fluid level pattern and was also divided into groups with or without extravasation as per CT findings. These CT findings were compared with the patients’ vital signs and laboratory investigation results. Results A total of 47 patients with CRSH were examined. Fluid level and non-fluid level patterns were observed in 28 (60%) and 19 (40%) patients, respectively. Anticoagulant therapy and extravasation were significantly correlated with the fluid level pattern. However, other clinicolaboratory outcomes, including shock index, hemoglobin, hematocrit, platelet count, and coagulation factors, showed no significant difference between the two patterns. In the comparison of hematomas with and without extravasation, none of the clinicolaboratory outcomes except for anticoagulant therapy showed significant differences. Conclusion CRSH with a fluid level pattern is significantly associated with extravasation. However, extravasation, which is generally suggestive of active bleeding, does not seem to be related to clinical severity in CRSH.

Computed tomography venography versus intravascular ultrasound in the diagnosis of iliofemoral vein stenosis

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 38-44
Author(s):  
Ming Ren Toh ◽  
Karthikeyan Damodharan ◽  
Han Hui Mervin Nathan Lim ◽  
Tjun Yip Tang
Keyword(s):  
Computed Tomography ◽  
Diagnostic Performance ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Diagnostic Tools ◽  
Venous Disease ◽  
Significant Stenosis ◽  
Vein Segment ◽  
Vein Stenosis ◽  
Computed Tomography Venography

Summary: Background: Iliofemoral vein stenosis can cause debilitating chronic venous disease. Diagnostic tools include both computed tomography venography (CTV) and intravascular ultrasonography (IVUS). We aim to compare the diagnostic performance of CTV and IVUS. Patients and methods: We performed a retrospective study of patients with chronic venous disease presenting with iliac vein compression or post-thrombotic limb symptoms, excluding those with acute deep vein thrombosis, high anaesthesia risk, or who had contrast allergy. All patients received CTV before IVUS, as part of the diagnostic work-up and intervention. The cross-sectional area (CSA) of iliofemoral vein segments obtained from both studies were compared against reference CSAs to derive percentage stenosis. A 50% reduction in CSA was considered significant. Results: We studied 50 patients between May 2018 and April 2019. 58% of patients had severe disease CEAP C5-6. 48% of patients had at least one vein segment with significant stenosis. The left proximal common iliac vein was the most commonly stenosed vein segment (n = 12, 24% on IVUS). CSA measurements from CTV were greater than those of IVUS, with a correlation coefficient of 0.57 (p < 0.005). Conversely, percentage stenosis measured on CTV was lower than on IVUS, with approximately one-third of significant stenosis missed on CTV (58 veins from CTV vs. 78 from IVUS, p < 0.005). With IVUS as the gold standard, CTV has low sensitivity (37.2%, 95% CI 26.5–48.9) and high specificity (92.5%, 95% CI 89.3–94.9) in detecting significant stenosis. Conclusions: CTV has limited diagnostic performance in identifying iliofemoral vein stenosis. Patients with normal CTV findings should proceed with IVUS imaging if the clinical features are supportive of iliofemoral vein stenosis.

scholarly journals Overview of chest involvement at computed tomography in children with coronavirus disease 2019 (COVID-19)

2020 ◽  
Author(s):  
Xuehua Peng ◽  
Yu Guo ◽  
Han Xiao ◽  
Wei Xia ◽  
Aiguo Zhai ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Young Children ◽  
Pulmonary Involvement ◽  
Chest Ct ◽  
Chi Square ◽  
Asymptomatic Group ◽  
Lung Lesions ◽  
Viral Shedding ◽  
Ct Findings ◽  
Asymptomatic Patients

Abstract Background Chest computed tomography (CT) findings in children with coronavirus disease 2019 (COVID-19) have been rarely reported in a comprehensive and systematic manner. Objective We investigated the chest CT findings in children with COVID-19, and explored the differences in these findings between symptomatic patients and asymptomatic patients. Materials and methods Demographic findings, clinical characteristics, duration of hospital stay and viral shedding, and chest CT findings in 201 children infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were retrospectively analyzed from January 15 to March 20, 2020, and divided into two groups: symptomatic group (n=136) and asymptomatic group (n=65). Chi-square test and Student’s t-test were used for statistical analysis. Results Symptomatic patients were mainly young children ≤3 years old (54/63, 86%),while asymptomatic patients were mainly children ≥ 6 years old (51/111, 46%). Fever (41%) and cough (41%) were the most common symptoms. Overall, 119/201 (59%) patients had chest CT findings, and symptomatic patients accounted for 82% (98/119). The CT findings presented as bilateral multiple lesions (60/119, 50.4%), ground-glass opacities (83/119, 70%) and/or consolidation (44/119, 37%) with a peripheral and subpleural distribution (62/83, 75%). Fifteen of 87 (7.2%) patients with lung lesions showed complete lesion absorption, and 42/87 (48%) improved within a mean of 9.1 (standard deviation [SD] 3.2) days. The mean duration of viral shedding was 8.7 (SD 4.9) days. Pleural effusion was very rare. No lymphadenopathy was found in either group. Conclusion Symptoms associated with pulmonary involvement were most common in infants and young children. The lung lesions of most patients were absorbed and improved in about 9 days.

Sinus Computed Tomography Imaging in Pediatric Cystic Fibrosis

2016 ◽  
Vol 155 (1) ◽  
pp. 160-165 ◽  
Author(s):  
Ozgul Gergin ◽  
Kosuke Kawai ◽  
Robert D. MacDougall ◽  
Caroline D. Robson ◽  
Ethan Moritz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cystic Fibrosis ◽  
Radiation Exposure ◽  
Preoperative Evaluation ◽  
Tertiary Care ◽  
Case Series ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Study Objective ◽  
Significant Difference

Study Objective To evaluate the prevalence of computed tomography (CT) sinus imaging in a pediatric cystic fibrosis (CF) population, determine changes in Lund Mackay (LM) scores over time, and estimate radiation exposure. Study Design Case series with chart review. Setting Tertiary care children’s hospital. Subjects and Methods In total, 202 pediatric patients with CF who underwent endoscopic sinus surgery (ESS) were included. The total number of CT scans was calculated for each patient, with specific focus on the indications for and subsequent outcomes of the sinus CT scan subgroup. Results Patients underwent a total of 1718 CT scans, 832 of which were sinus CT scans (mean of 4.2 sinus scans per patient). Disease evaluation (54%) and preoperative planning (35%) were the most common indications. Otolaryngologists were more likely to order imaging for preoperative evaluation, and those scans were more likely to result in surgery compared with those requested by other physicians ( P < .001). Ninety CT scans (10.8%) led to no change in management. There was no significant difference in LM scores between patients admitted to the hospital or prescribed antibiotics and those who were not. There was also no significant change in LM score following ESS after adjusting for age and sex ( P = .23). Conclusion Based on LM scores, all sinus CT scans in patients with CF reveal moderate to severe sinus disease. Effort should be made to minimize radiation exposure in patients with CF by limiting sinus CT scans to the preoperative context or for evaluation of potential sinusitis complications.

scholarly journals A prospective study of number of attempts required in conventional image guided transthoracic fine needle aspiration for pulmonary lesions

2019 ◽  
Vol 6 (3) ◽  
pp. 969
Author(s):  
Ramesh C. Sagar ◽  
K. V. Veerendra Kumar ◽  
S. D. Madhu ◽  
M. Malathi
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Ct Guidance ◽  
Lung Lesions ◽  
Fine Needle ◽  
Pulmonary Lesions ◽  
Image Guided ◽  
Significant Difference

Background: With the established role of computed tomography (CT) screening for lung cancer, and the broad application of high-resolution CT, the solitary pulmonary nodule (SPN) are increasingly detected. The discovery rate of pulmonary lesions is evidently elevated these days: most of them are benign, but some of them are lung cancer. Lung cancer remains the leading cause of cancer deaths worldwide. The diagnosis of this pulmonary lesion is difficult and obtaining tissue samples to conduct pathology examination is the key point. Image guided transthoracic fine needle aspiration (TTFNA) of lung lesions is a well established, safe, and rapid method for achieving a definitive diagnosis for most lung lesions.Methods: TTFNA were performed in 160 patients attended the OPD and admitted due to pulmonary lesions between September 2016 and May 2017. After detailed characterization by computed tomography and compared with chest x-ray, TTFNA was done. Number of attempts, reasons for multiple attempts, and final FNAC diagnosis were recorded.Results: When CT guidance was used sufficient material was obtained in 91.03% of patients, but with USG guidance insufficient material was reason for repeated attempts in nearly 25.25% of cases. Bloody aspirate was reason in total 13.54% patients and there was no significant difference between CT guidance and USG guidance (14.29% v/s 13.13% respectively). Again only inflammatory cells was reason for repeated attempts, in CT guidance 8.93% and in USG guidance 20.20%, attributed to localization of needle in both techniques.Conclusions: CT guided FNAC should be considered in diagnosis of lung lesions if computerized tomography is not contraindicated. Further, routine need for advanced imaging techniques like 3D computerized tomographic study for localizing lesions in lung to reduce the number of attempts should be considered.

scholarly journals The mean severity score and its correlation with common computed tomography chest manifestations in Egyptian patients with COVID-2019 pneumonia

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mona A. F. Hafez
Keyword(s):  
Computed Tomography ◽  
Disease Severity ◽  
Severity Score ◽  
Descriptive Analysis ◽  
Multislice Ct ◽  
Mediastinal Lymphadenopathy ◽  
Diagnostic Tools ◽  
Ct Findings ◽  
Egyptian Patients ◽  
The Mean

Abstract Background Computed tomography (CT) is one of the main diagnostic tools for early detection and management of coronavirus disease 2019 (COVID-19) pneumonia. This study aims to highlight the commonly encountered CT findings in patients with COVID-19 pneumonia in Egypt and the mean severity score and its correlation with the imaging findings. This study involved 200 patients with pathologically confirmed COVID-19 infection; non-contrast CT chest was performed for all cases; in addition, CT findings and severity score (CT-SS) were then assessed using descriptive analysis, and the correlation between the CT findings and disease severity was assessed. Results The ground-glass densities and peripheral adhesions were the most typical CT findings. Prominent interlobular septations; bronchial thickening/dilatation; CT signs of crazy-paving, halo, and reversed halo; and reactive mediastinal lymphadenopathy were significantly correlated with disease severity. The mean CT-SS of Egyptian patients with COVID-19 pneumonia was 11.2 (mild to moderate severity). Conclusion Multislice CT played a vital role in the early identification of Egyptian patients with COVID-19 pneumonia. The assessment of the CT severity score of COVID-19 is essential for the extent of pneumonia involvement to help clinicians achieve the purpose of early diagnosis and accurate treatment.

Simple Analysis of the Computed Tomography Features of Gastric Schwannoma

2019 ◽  
Vol 70 (3) ◽  
pp. 246-253 ◽  
Author(s):  
Jian Wang ◽  
Wenming Zhang ◽  
Xiaoxuan Zhou ◽  
Junliang Xu ◽  
Hong-jie Hu
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Growth Pattern ◽  
Gastric Body ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Continuous Variables ◽  
Gastric Schwannoma ◽  
Ct Findings ◽  
Significant Difference

Objective The objective of this study was to assess the computed tomography (CT) findings of gastric schwannoma (GS) and identify the difference between large (> 5 cm) and small (≤ 5 cm) GS. Materials and Methods CT findings of 38 pathologically proven cases of GSs were retrospectively reviewed. The CT evaluation of GS included categorical variables (location, contour, growth pattern, enhancement pattern, necrosis, ulceration, calcification, and lymph nodes) and continuous variables (size, CT value of 3 phases, and enhancement degree). The lesion was divided into 2 groups (large [> 5 cm] and small [≤ 5 cm] GS) according to the tumor size. The Fisher exact test was used for categorical variables and the Student t or Mann-Whitney U test for continuous variables. Results Of the 38 patients, there were 32 women and 6 men. The median age was 54.5 years (range 39–79). Most of patients (65.8%, [25 of 38]) had nonspecific gastrointestinal symptoms such as abdominal or gastric pain, fullness and discomfort, bleeding, and melena. The tumors were mainly located in the stomach body (71.1% [27 of 38]), and the mean diameter was 3.7 cm (range 1.5 cm-10.3 cm), of which included large (> 5 cm) (n = 8) and small (≤ 5 cm) (n = 30). All of the GSs were benign, 9 of whom had palpable perigastric lymph nodes, which confirmed by pathology for the reactive inflammatory hyperplasia. Growth pattern, pattern of enhancement, necrosis, calcification, surface ulceration, and lymph node in the CT images were found to be significant variables for differentiating large (> 5 cm) and small (≤ 5 cm) GS ( P < .05). Conclusion GSs were predominantly located at the gastric body and occurred most frequently in women between the ages of 40–70 years, and showed gradual enhancement after contrast enhancement. Palpable perigastric lymph nodes could not be considered as malignant factor of GS. There 7 computed CT criteria are significant difference between large (> 5 cm) and small (≤ 5 cm) GS.

scholarly journals Diagnostic Performance of Plain Film, Ultrasonography, and Computed Tomography in Nasal Bone Fractures: A Systematic Review

2018 ◽  
Vol 26 (4) ◽  
pp. 286-292 ◽  
Author(s):  
Kun Hwang ◽  
Joon Soo Jung ◽  
Hun Kim
Keyword(s):  
Computed Tomography ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Plain Film ◽  
Lateral View ◽  
Performance Accuracy ◽  
Significant Difference ◽  
Sensitivity Specificity

Purpose: The aim of this study was to compare the diagnostic performance (accuracy, sensitivity, specificity, positive predictive value, and negative predictive value) of plain film (PF), ultrasonography (USG), and computed tomography (CT) in diagnosing nasal bone fractures (NBFs). Methods: In a search of PubMed and Scopus, “nasal bone fracture” AND “X-ray OR CT OR USG OR MRI” were searched. Among the 369 titles from PubMed and 379 titles from Scopus, 257 duplicate titles were excluded and 491 titles were reviewed. Among them, 36 full articles were reviewed. From these, 21 were excluded and 1 mined article was added; thus, 16 articles were reviewed. Results: The accuracy of CT (94.4% ± 2.3%) was significantly higher ( P < .001) than that of USG (85.0% ± 3.6%). The accuracy of USG was significantly higher ( P < .001) than that of PF (67.7% ± 4.7%). Computed tomography (89.3% ± 3.1%) and USG (87.2% ± 3.3%) were significantly more sensitive than PF ( P < .001 and P < .001, respectively). The specificity of CT (94.2% ± 2.3%) was significantly higher ( P = .001) than that of USG (87.4% ± 3.3%). The specificity of USG was significantly higher ( P < .001) than that of PF (67.8% ± 4.7%). Among the PF techniques, combining a lateral view and the Water’s view (71.8% ± 4.5%) had significantly higher accuracy than a lateral view alone (62.4% ± 4.8%) or the Water’s view alone (61.0% ± 4.9%). In USG, there was no significant difference ( P = .300) in accuracy among lateral and dorsal views (95.8% ± 2.0%), a lateral view alone (84.2% ± 3.7%), and a dorsal view alone (84.2% ± 3.6%). Conclusion: The results of this review might be helpful in choosing the most appropriate diagnostic tool in patients suspected having NBF.

Portable Chest Radiography Through Glass During COVID-19 Pandemic—Initial Experience in a Tertiary Care Center

2020 ◽  
pp. 084653712094288
Author(s):  
Archana Rai ◽  
Noah Ditkofsky ◽  
Bryce Hunt ◽  
Margaret Dubrawski ◽  
Djeven Deva ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Chest Radiographs ◽  
Initial Experience ◽  
Conventional Radiograph ◽  
Diagnostic Quality ◽  
Radiology Reports ◽  
Significant Difference ◽  
Portable Chest ◽  
Conventional Manner

Background: Portable chest radiograph for COVID-19 positive patients and persons under investigation can be acquired through glass doors or walls of isolation rooms to limit exposure to the pathogen and conserve resources. Purpose: To report our initial experience with acquiring portable chest radiographs through glass doors of isolation rooms. Methods: Only 1 of 2 radiology technologist team members donned personal protective equipment and stayed inside the isolation room, while the second technologist and the radiography unit remained outside during the procedure. First hundred radiographs acquired through glass at the emergency department of our institute formed the “through glass radiograph” group. Hundred consecutive portable chest radiographs performed in a conventional manner formed the “conventional radiograph” group for comparison. Imaging database and feedback from operations leader were used to identify occurrences of a failed procedure. Suggestion of repeating the study and comments related to quality of the study were recorded from the reports of the staff radiologist. Results: There was no instance of failed acquisition, nondiagnostic examination, or suggestion of repetition in both groups. No significant difference in the number of reports with quality related remarks ( P > .05) was found between the 2 groups. Radiography through glass doors was associated with increased suboptimal positioning related remarks in radiology reports ( P < .05). No significant association was identified among other comments about image quality. Conclusion: Our initial clinical experience suggests that the acquisition of portable chest radiographs through the glass doors of isolation rooms is technically feasible and results in diagnostic quality studies.

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