Clinical Diagnostic Accuracy and Magnetic Resonance Imaging of Patients Referred by Physical Therapists, Orthopaedic Surgeons, and Nonorthopaedic Providers

2005 ◽  
Vol 35 (2) ◽  
pp. 67-71 ◽  
Author(s):  
Josef H. Moore ◽  
Donald L. Goss ◽  
Richard E. Baxter ◽  
Thomas M. DeBerardino ◽  
Liem T. Mansfield ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Physical Therapists ◽  
Resonance Imaging ◽  
Orthopaedic Surgeons ◽  
Clinical Diagnostic

scholarly journals AB1086 POWER DOPPLER AND SPECTRAL DOPPLER ULTRASOUND IN SUSPECTED ACTIVE SACROILIITIS: A COMPARISON WITH MAGNETIC RESONANCE IMAGING AS GOLD STANDARD

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1832.1-1832
Author(s):  
P. Falsetti ◽  
E. Conticini ◽  
C. Baldi ◽  
M. Bardelli ◽  
S. Gentileschi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Doppler Ultrasound ◽  
Gold Standard ◽  
Clinical Characteristics ◽  
Power Doppler ◽  
Resonance Imaging ◽  
Asas Criteria ◽  
Spectral Doppler

Background:SIJ involvement is a characteristic feature of Spondylarthritis (SpA). Magnetic Resonance imaging (MRI) has been included in the new Assessment of SpA International Society (ASAS) criteria for the classification of Axial SpA. Gray scale US, Color Doppler ultrasound (CDUS), contrast-enhanced CDUS, and spectral Doppler (SD) US has been used in few works to evaluate the inflammatory activity of the SIJ with not conclusive results. Power Doppler ultrasound (PDUS) was not yet applied to the study of SIJ with active SI.Objectives:The aim of this work was to study with PDUS and SD US the SIJ of patients with suspected active SI, to describe inflammatory flows with spectral wave analysis (SWA) in duplex Doppler US, and to correlate US data with clinical characteristics and the presence of bone marrow edema (BME) in MRI.Methods:22 patients (18 females and 4 males, mean age 35 years) with new onset of inflammatory back pain (IBP), were included. Every patient underwent an US examination in prone position. The sonographers were blinded to the clinical data of the patient. A Esaote Twice US machine, equipped with a convex multifrequency 1-8 MHz probe, was used, with standardized parameters: 1-5 MHz for gray scale, 1.9-2.3 MHz frequency for Doppler with Pulse Repetition Frequency (PRF) of 1.0 KHz and a color gain just under the artifact limit. SIJ was located as the hypoechoic triangle delimited between the sacrum and iliac bone, and the posterior SI ligament as the upper margin. The first sacral foramen was always localized to avoid measurement of the normal pre-sacral arteries. The PDUS was applied, and if any signals were detected in the SIJ, they were scored with a 3-points scale: 0= absence of signals, 1= isolate vessels, 2= more than one vessel. The signals were also classified as intra-articular or peri-articular. The same vessels were also evaluated using quantitative SD calculating the Resistive Index (RI=peak of systolic flow- end diastolic flow/peak systolic flow), ranging between 0 and 1. Every patient underwent MRI of SIJ within the same week, before treatment. A statistical analysis was performed, estimating the sensitivity and specificity against the gold standard (presence of BME in the same SIJ according to ASAS criteria). The Spearman rank not-parametric test was applied to correlate the presence and grading of BME with PDUS grading and RI. A regression analysis was applied between PDUS results and clinical characteristics.Results:In 14/22 SIJ MRI revealed BME. In 13 of them, PDUS confirmed abnormal hypervascularisation in the intrarticular portion of SI, and in 3 in the periarticular site too. Two SIJ showed hypervascularisation at PD with no BME in MRI. A significant correlation was demonstrated between positivity and grading of PD and presence of BME in MRI (p=0.0005). SD analysis demonstrated low Resistance Index (RI) values in 14 SIJ (mean 0.57). An inverse correlation was demonstrated between RI and grading of BME in MRI (r= -0,6229, p= 0,044). The diagnostic accuracy of SD for detection of active SI varied on the basis of RI cut-off value. The best values of sensitivity (62,5%) and specificity (61,5%) were obtained with a RI cut-off values of 0.60. A multiple regression model demonstrated a significant relationship between PDUS signals and ASDAS (p=0.0382), but not with inflammatory reactants.Conclusion:PDUS and SD US of SIJ can be useful as first imaging assessment in suspected active SI, demonstrating a good diagnostic accuracy compared with MRI. Intra-articular low RI values (<0.60) on SD indicate active SI with good accuracy. Moreover, PDUS signals into the SIJ correlate with clinical symptoms but not with inflammation reactants.Figure 1.Doppler US in SI.Right SIJ with a Doppler signal along the posterior SIJ ligament, and another Doppler signal into the joint, where SD analysis gave a RI of 0,62.Disclosure of Interests:None declared

2309 IMPACT OF CLINICAL PARAMETERS ON THE DIAGNOSTIC ACCURACY OF ENDORECTAL COIL MAGNETIC RESONANCE IMAGING FOR THE DETECTION OF PROSTATE CANCER

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Daniela Colleselli ◽  
Joerg Hennenlotter ◽  
Stefan Krueger ◽  
David Schilling ◽  
Georgios Gakis ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Clinical Parameters ◽  
Resonance Imaging ◽  
Endorectal Coil

scholarly journals Using Tuning-Fork Tests in Diagnosing Fractures

2016 ◽  
Vol 51 (6) ◽  
pp. 498-499 ◽  
Author(s):  
Chelsey M. Toney ◽  
Kenneth E. Games ◽  
Zachary K. Winkelmann ◽  
Lindsey E. Eberman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Clinical Practice ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Strong Evidence ◽  
Bone Scan ◽  
Tuning Fork ◽  
Reference Standard ◽  
Resonance Imaging ◽  
Likelihood Ratios

Reference/Citation: Mugunthan K, Doust J, Kurz B, Glasziou P. Is there sufficient evidence for tuning fork tests in diagnosing fractures? A systematic review. BMJ Open. 2014;4(8):e005238. Clinical Question: Does evidence support the use of tuning-fork tests in the diagnosis of fractures in clinical practice? Data Sources: The authors performed a comprehensive literature search of AMED, CAB Abstracts, CINAHL, EMBASE, MEDLINE, SPORTDiscus, and Web of Science from each database's start to November 2012. In addition, they manually searched reference lists from the initial search result to identify relevant studies. The following key words were used independently or in combination: auscultation, barford test, exp fractures, fracture, tf test, tuning fork. Study Selection: Studies were eligible based on the following criteria: (1) primary studies that assessed the diagnostic accuracy of tuning forks; (2) measured against a recognized reference standard such as magnetic resonance imaging, radiography, or bone scan; and (3) the outcome was reported using pain or reduction of sound. Studies included patients of all ages in all clinical settings with no exclusion for language of publication. Studies were not eligible if they were case series, case-control studies, or narrative review papers. Data Extraction: Potentially eligible studies were independently assessed by 2 researchers. All relevant articles were included and assessed for inclusion criteria and value using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool, and relevant data were extracted. The QUADAS-2 is an updated version of the original QUADAS and focuses on both the risk of bias and applicability of a study through a series of questions. A third researcher was consulted if the 2 initial reviewers did not reach consensus. Data for the primary outcome measure (accuracy of the test) were presented in a 2 × 2 contingency table to show sensitivity and specificity (using the Wilson score method) and positive and negative likelihood ratios with 95% confidence intervals. Main Results: A total of 62 citations were initially identified. Six primary studies (329 patients) were included in the review. The 6 studies assessed the accuracy of 2 tuning-fork test methods (pain induction and reduction of sound transmission). The patients ranged in age from 7 to 84 years. The prevalence of fracture in these patients ranged from 10% to 80% using a reference standard such as magnetic resonance imaging, radiography, or bone scan. The sensitivity of the tuning-fork tests was high, ranging from 75% to 92%. The specificity of the tuning-fork tests had a wide range of 18% to 94%. The positive likelihood ratios ranged from 1.1 to 16.5; the negative likelihood ratios ranged from 0.09 to 0.49. Conclusions: The studies included in this review demonstrated that tuning-fork tests have some value in ruling out fractures. However, strong evidence is lacking to support the use of current tuning-fork tests to rule in a fracture in clinical practice. Similarly, the tuning-fork tests were not statistically accurate in the diagnosis of fractures for widespread clinical use. Despite the lack of strong evidence for diagnosing all fractures, tuning-fork tests may be appropriate in rural and remote settings in which access to the gold standards for diagnosis of fractures is limited.

Comparison of Diagnostic Accuracy of Magnetic Resonance Spectroscopy with Conventional Magnetic Resonance Imaging for Brain Tumors and Correlation with Histopathology as Gold Standard

2021 ◽  
Vol 15 (9) ◽  
pp. 4009-4011
Author(s):  
Saulat Sarfraz ◽  
Mahwish Farzana
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Brain Tumors ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Age Groups ◽  
Resonance Spectroscopy ◽  
Resonance Imaging ◽  
Conventional Mri

Background: In spite of recent advances in the use of diagnostic imaging modalities none of them has a hundred percent accuracy. So, misdiagnosis still occurs. Many trials are being done to evaluate the accuracy of these tools individually or in combination. The most useful investigation is MRI which broadly gives information of lesion as well its relationship with surrounding structures. While magnetic resonance spectroscopy further characterizes the lesion into benign or malignant. So this study is bit superior giving more details. By enlarge histopathology is gold standard for ultimate diagnosis. However these radiological investigations are extremely important for preoperative planning as well management of the lesion. In this study we compare the diagnostic accuracy of Magnetic Resonance Spectroscopy (MRS) with conventional MRI (Magnetic Resonance Imaging) sequences for diagnosis of brain tumors keeping histopathology as gold standard. Methods: The study was performed in 150 clinically suspected cases which were referred to Radiology Department from OPD, Indoor, Emergency and private sources from outside the hospital. Results: Majority 85(56.7%) were adult males and 65(43.3%) were adult females. The study was divided into two major age groups. There were 33cases (22%) with average age 20-35 years. The other age group 36-50 years had 40(26.7%) Majority of the cases 77(51.3%) were of average >50 years of age. The higher age groups showed a female dominance. Histopathology of 100(66.7%) cases confirmed positive and 50(33.3%) negative for MR Spectroscopy. On comparison of conventional MRI with contrast, and Histopathology it was observed that the sensitivity of MRI was 74.0% and the specificity 82.0%.The positive and negative predictive values gave a lower accuracy rate of 76.6%. Conclusion: The conclusion of our study is that MRS is a rigorous, non-invasive, safe and convenient imaging modality for the evaluation of brain tumors as compared to MRI. Keywords: Brain tumors, MRI, MRS, Histopathology

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