Diagnosis of Malignant Pleural Effusion Using CT Scan and Pleural-Fluid Cytology Together. A Preliminary Case–Control Study

Background Computed tomography (CT) can be used as the primary screening modality for the evaluation of patients suspected of having acute mesenteric ischemia known to show high sensitivity and specificity rates. Purpose To prove the value of CT in patients with pathological abdominal findings following cardiac surgery. Material and Methods In a retrospective case-control study, 12 different CT scan parameters of patients with or without mesenteric ischemia following cardiac surgery were compared using univariate and logistic regression analyses. Results Of 14,176 patients, 133 (0.9%) received an abdominal CT scan during postoperative care due to pathological abdominal findings. Sixty-eight patients were diagnosed with acute mesenteric ischemia. In-hospital mortality was 73.5% for this group. CT parameters with the highest specificity for indicating colonic ischemia were intestinal (99%) or porto-venous (96%) pneumatosis, abnormal contrast medium enhancement (89%), and occlusion of the proximal inferior mesenteric artery (81%). All of those parameters showed low sensitivity levels in the range of 15%–23%. A statistically significant association between acute mesenteric ischemia and CT appearance was obtained for contrast medium enhancement (odds ratio [OR] 12.2, 95% confidence interval [CI] 1.5–99.2) and intestinal pneumatosis (OR 21.0, 95% CI 2.7–165.2) only. Conclusion The typical CT criteria indicating mesenteric ischemia lose their accuracy in patients under critical clinical conditions. As CT remains the first-line diagnostic imaging modality for abnormal abdominal findings following cardiac surgery, negative signs should not prevent early laparotomy if clinical suspicion remains high.

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T1957 Metabolic Syndrome and Visceral Obesity Quantified By Abdominal CT Scan As Risk Factors for Reflux Esophagitis: A Case-Control Study of 7078 Health Check-Up Subjects

Gastroenterology ◽

10.1016/s0016-5085(08)62746-8 ◽

2008 ◽

Vol 134 (4) ◽

pp. A-587

Author(s):

Su Jin Chung ◽

Donghee Kim ◽

Seon Hee Lim ◽

Joo Sung Kim ◽

Hyun Chae Jung ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Ct Scan ◽

Reflux Esophagitis ◽

Case Control Study ◽

Visceral Obesity ◽

Case Control ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

Control Study

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Computed Tomographic Findings Characteristic for Encapsulating Peritoneal Sclerosis: A Case-Control Study

Peritoneal Dialysis International ◽

10.1177/089686080902900508 ◽

2009 ◽

Vol 29 (5) ◽

pp. 517-522 ◽

Cited By ~ 48

Author(s):

Anniek Vlijm ◽

Jaap Stoker ◽

Shandra Bipat ◽

Anje M. Spijkerboer ◽

Saffire S.K.S. Phoa ◽

...

Keyword(s):

Computed Tomography ◽

Peritoneal Dialysis ◽

Ct Scan ◽

Case Control Study ◽

Case Control ◽

Ct Scans ◽

Computed Tomographic ◽

Ct Findings ◽

Control Study

Background Computed tomography (CT) is often used to confirm the diagnosis of encapsulating peritoneal sclerosis (EPS) but there is no consensus on specific CT abnormalities. To establish CT findings characteristic for EPS, we compared CT findings between EPS patients and long-term peritoneal dialysis (PD) patients without EPS. Methods We included as cases all EPS patients in our center from 1996 to 2008 that underwent a CT scan at the time of diagnosis. Controls were all other long-term PD patients (PD duration ≥ 4 years) without EPS that had a CT scan for different reasons. The CT scans were blindly and independently reviewed by 3 radiologists: 2 abdominal radiologists with PD knowledge (Observers 1 and 2) and 1 radiologist without PD experience (Observer 3). Results We included 15 EPS patients and 16 controls. Observer 1 found 6 CT findings that were significantly more often present in EPS than in controls ( p ≤ 0.05): peritoneal enhancement, thickening, and calcifications; adhesions of bowel loops; signs of obstruction; and fluid loculation/septation. Observer 2 scored almost identically but Observer 3 scored differently. The sensitivity and specificity of a combination of specific CT findings were, respectively, 100% and 94% for Observers 1 and 2, and 79% and 88% for Observer 3. Conclusion CT scans showed characteristic abnormalities that were significantly more often present in EPS patients compared to long-term PD control patients. CT can be used to confirm the diagnosis of EPS when experienced radiologists apply a combination of specific CT findings.

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Pleural fluid ‘cell block’ analysis in malignant pleural effusion: sensitive, superior over fluid cytology and suitable for immunohistochemistry analysis (IHC), will decrease need for thoracoscopy guided procedures

10.1183/1393003.congress-2017.pa4308 ◽

2017 ◽

Author(s):

Patil Shital ◽

Mazhar Mirza ◽

Gajanan Gondhali

Keyword(s):

Pleural Effusion ◽

Pleural Fluid ◽

Malignant Pleural Effusion ◽

Cell Block ◽

Immunohistochemistry Analysis ◽

Fluid Cell ◽

Fluid Cytology

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Predictors of Renal Function and Calcifications in Primary Hyperparathyroidism: A Nested Case-Control Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-00923 ◽

2018 ◽

Vol 103 (9) ◽

pp. 3574-3583 ◽

Cited By ~ 5

Author(s):

Henriette Ejlsmark-Svensson ◽

Lise Sofie Bislev ◽

Lars Rolighed ◽

Tanja Sikjaer ◽

Lars Rejnmark

Keyword(s):

Renal Function ◽

Primary Hyperparathyroidism ◽

Ct Scan ◽

Impaired Renal Function ◽

Case Control Study ◽

Case Control ◽

University Hospital ◽

Calcium Excretion ◽

Nested Case Control ◽

Control Study

Abstract Context Some patients with primary hyperparathyroidism (PHPT) develop renal calcifications. Investigation of urinary and nonurinary risk factors are essential. Objective We aimed to study the prevalence and potential biochemical predictors of renal calcifications. Design Nested case-control study. Setting University hospital. Participants We identified 792 patients with PHPT from 2005 to 2015. We used biochemical data to validate the diagnosis of PHPT. Main Outcome Measures The prevalence of renal calcifications defined as nephrolithiasis or nephrocalcinosis assessed by a routine CT scan at the time of diagnosis. Results A total of 792 patients with PHPT were identified among whom 617 patients (78%) had a CT scan preformed. We found a prevalence of renal calcifications of 23%, equally frequent between sexes. A total of 76 patients (12%) had nephrolithiasis and 75 patients (12%) had nephrocalcinosis where 7 patients (1%) had both nephrolithiasis and nephrocalcinosis. Compared with patients without renal calcifications, patients with renal calcifications had significantly higher levels of ionized calcium, parathyroid hormone, and 24-hour calcium excretion (Pall < 0.01). Patients with nephrocalcinosis had higher plasma levels of phosphate and a higher calcium-phosphate product compared with patients with nephrolithiasis (Pall < 0.05). Impaired renal function (estimated glomerular filtration rate <60 mL/min) was observed in 12% of patients. However, no differences in renal function were observed between those with and without renal calcifications. Conclusion Renal calcifications are frequent in patients with PHPT and are associated with the severity of the disease. Impaired renal function is also common in PHPT, but renal function was not associated with renal calcifications.

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