Efficacy of MRI Versus Arthroscopy for Evaluation of Sinus Tarsi Syndrome

2008 ◽  
Vol 29 (11) ◽  
pp. 1111-1116 ◽  
Author(s):  
Keun-Bae Lee ◽  
Long-Bin Bai ◽  
Jin-Gyoon Park ◽  
Eun-Kyoo Song ◽  
Jae-Jun Lee
Keyword(s):  
Diagnostic Efficiency ◽  
Full Agreement ◽  
Level Of Evidence ◽  
Predictive Values ◽  
Sinus Tarsi ◽  
Arthroscopic Findings ◽  
Sinus Tarsi Syndrome ◽  
Prospective Comparative Study ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Background: Magnetic resonance imaging (MRI) has been used to diagnose sinus tarsi syndrome (STS) because of its non-invasiveness and accuracy. The purpose of the present study was to evaluate the diagnostic efficiency of MRI compared with subtalar arthroscopy for STS. Materials and Methods: Twenty-eight patients (30 feet) who had undergone both MRI and subtalar arthroscopy for STS were evaluated. MRI results were compared with arthroscopic findings, which were considered the standard. Sensitivity, specificity, and positive and negative predictive values were calculated, and correlations between MRI and arthroscopic findings were investigated. Results: MRI was found to detect interosseous talocalcaneal ligament (ITCL) tears, cervical ligament (CL) tears, sinus tarsi fat alterations, and synovial thickening, with sensitivities, specificities, positive and negative predictive accuracies of: 44%, 60%, 85%, 18% (ITCL tears); 73%, 89%, 80%, 86% (CL tears); 71%, 92%, 93%, 71% (sinus tarsi fat alterations); and 86%, 87%, 67%, 95% (synovial thickening). Correlations between MRI and arthroscopic findings showed full agreement in 10%, partial agreement in 50%, and no agreement in 40%. Conclusion: MRI is useful for detecting CL tears, sinus tarsi fat alterations, and synovial thickening, but is inadequate for correctly detecting ITCL tears. Level of Evidence: II, Prospective Comparative Study

S216 – Is Oculomotor Testing Useful in the Modern Era?

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P148-P148
Author(s):  
Zameel Dewji ◽  
Brian W Blakley
Keyword(s):  
Diagnostic Odds Ratio ◽  
Likelihood Ratios ◽  
Level Of Evidence ◽  
Predictive Values ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity ◽  
The Cost ◽  
Modern Era

Objectives To understand the role of oculomotor testing in the era of advanced imaging with MRI. Methods First, the literature was evaluated systematically to determine the level of evidence that oculomotor testing is sensitive in central nervous system lesions. Next, the sensitivity and specificity of saccade, pursuit, and gaze testing in detection of brain abnormalities were assessed using a database of 561 patients who underwent ENG using magnetic resonance imaging (MRI) as the “gold standard.” Among the abnormal MRI scans, oculomotor testing was abnormal in 1 and normal in 37. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), positive and negative likelihood ratios (PLR and NLR), and the diagnostic odds ratio (OR) with 95% confidence interval (± CI) were calculated. Results For oculomotor testing, our data which concur with the literature indicate: Sensitivity 2.6%, (± 0.005–1.1); Specificity 96%, ± (0.89–0.98); Diagnostic OR 0.71 ± (0.065–5.6); PPV 20% ± (0.043, −0.64); NPV 71% ±(0.62, 0.78). Conclusions Our data suggest that oculomotor testing adds little diagnostic information. The cost and benefit of oculomotor testing are low.

Discriminating Malignancy in Thyroid Nodules: The Nomogram Versus the Kwak and ACR TI-RADS

2020 ◽  
Vol 163 (6) ◽  
pp. 1156-1165
Author(s):  
Juan Xiao ◽  
Qiang Xiao ◽  
Wei Cong ◽  
Ting Li ◽  
Shouluan Ding ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Diagnostic Study ◽  
Diagnostic Efficiency ◽  
Training Set ◽  
Multivariable Logistic Regression Model ◽  
Predictive Values ◽  
Validation Set ◽  
Sensitivity Specificity

Objective To develop an easy-to-use nomogram for discrimination of malignant thyroid nodules and to compare diagnostic efficiency with the Kwak and American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS). Study Design Retrospective diagnostic study. Setting The Second Hospital of Shandong University. Subjects and Methods From March 2017 to April 2019, 792 patients with 1940 thyroid nodules were included into the training set; from May 2019 to December 2019, 174 patients with 389 nodules were included into the validation set. Multivariable logistic regression model was used to develop a nomogram for discriminating malignant nodules. To compare the diagnostic performance of the nomogram with the Kwak and ACR TI-RADS, the area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values were calculated. Results The nomogram consisted of 7 factors: composition, orientation, echogenicity, border, margin, extrathyroidal extension, and calcification. In the training set, for all nodules, the area under the curve (AUC) for the nomogram was 0.844, which was higher than the Kwak TI-RADS (0.826, P = .008) and the ACR TI-RADS (0.810, P < .001). For the 822 nodules >1 cm, the AUC of the nomogram was 0.891, which was higher than the Kwak TI-RADS (0.852, P < .001) and the ACR TI-RADS (0.853, P < .001). In the validation set, the AUC of the nomogram was also higher than the Kwak and ACR TI-RADS ( P < .05), each in the whole series and separately for nodules >1 or ≤1 cm. Conclusions When compared with the Kwak and ACR TI-RADS, the nomogram had a better performance in discriminating malignant thyroid nodules.

scholarly journals TP8.1.12 Diagnostic Utility of MRI in the Evaluation of Potential Malignancy in Patients Presented with Nipple Discharge

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nixon Phua Cher Yang ◽  
Muhammad Adeel Javed Butt ◽  
Parmvir Singh Nijjar ◽  
Saung Phyu ◽  
Musa Barkeji
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Ductal Carcinoma ◽  
Nipple Discharge ◽  
Diagnostic Value ◽  
Predictive Values ◽  
Imaging Tool ◽  
Additional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Abstract Aims Nipple discharge is a presentation commonly seen at breast clinics. It is conventionally evaluated with physical examination and sonography( or mammography). The aim of this study is to investigate the diagnostic value of magnetic resonance imaging (MRI) as an additional imaging tool in the evaluation of potential malignancy in patients presented with nipple discharge. Methods A retrospective evaluation of 85 patients with nipple discharge who underwent breast ultrasound (USS) and MRI between 04/06/2008 and 25/10/2019 was conducted. Clinical notes, radiographic reports and biopsy results were reviewed. Sensitivity, specificity, positive predictive value and negative predictive value of USS and MRI were calculated. Results Out of the 85 patients (all female; mean age 45.33 +/- 12.93 years old) with nipple discharge, 11 were found to have biopsy-proven malignancy (invasive ductal carcinoma/ ductal carcinoma in situ; 12.94% risk). USS failed to identify seven malignancies (27.27% sensitivity) while MRI missed three malignancies (72.72% sensitivity). USS falsely identified four malignancies from 74 patients with no malignancy (94.59% specificity) while MRI only falsely identified one case (98.65% specificity). For patients with negative USS results (U1/U2/U3) or negative MRI results (BI-RADS category 1,2 or 3), the negative predictive values of USS is 89.74% while that of MRI is 96.05%. The positive predictive values of USS and MRI are 42.86% and 88.88% respectively. Conclusion Compared to USS, MRI has a higher sensitivity, specificity, positive predictive value and predictive value. It will be a valuable addition to the standard nipple discharge evaluation workup to help rule out malignancy.

scholarly journals Prediction of 2-year work participation in sickness absentees with neck or shoulder pain: the contribution of demographic, patient-reported, clinical and imaging information

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Line Thorndal Moll ◽  
Anne Mette Schmidt ◽  
Christina Malmose Stapelfeldt ◽  
Merete Labriola ◽  
Ole Kudsk Jensen ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Area Under The Curve ◽  
Work Participation ◽  
Prognostic Variables ◽  
Predictive Values ◽  
Additional Information ◽  
Work Outcome ◽  
Patient Reported ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Abstract Background In cases of neck and shoulder pain, the responsibility for assessing work prognosis is held by clinicians with access to different domains of information. One of these domains is magnetic resonance imaging (MRI), and although MRI is increasingly used, it is unknown which domains of information contribute the most to the prediction of work prognosis. This retrospective cohort study explored the contribution of demographic, patient-reported, clinical, and MRI information to the prediction of work participation in sickness absentees with neck or shoulder pain. Methods From a secondary care setting, 168 sickness absentees with neck or shoulder pain were included. Based on registry data, a successful work outcome was defined as ≥50% work participation score (WPS) from Weeks 1 to 104 after enrolment. Prognostic variables were categorized into four domains (demographic, patient-reported, clinical, and MRI) resembling the order of information obtained in a clinical setting. Crude logistic regression analyses were used to identify prognostic variables for each domain (p < 0.2). This was followed by multivariable analyses including the identified variables in a domain-wise order. For each added domain, the probability of successful WPS was dichotomized leaving two possible classifications: ≥ 50% chance of successful WPS or not. In cross-tabulations of chance and the actual WPS outcome, positive and negative predictive values (PPV and NPV), sensitivity, specificity and area under the curve (AUC) were calculated. Results The combination of demographic and patient-reported variables yielded an NPV of 0.72 and a PPV of 0.67, while specificity was 0.82, sensitivity 0.54 and AUC 0.77. None of these values improved notably by adding clinical and MRI variables as predictors of successful WPS. Conclusions These results suggest that - among sickness absentees with neck or shoulder pain – clinical and MRI variables provide no additional information for the prediction of work participation compared with only demographic and patient-reported information.

New frontiers ahead focal therapy postoperative follow-up: What is the real role of MRI in this setting?

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. e539-e539
Author(s):  
Igor Nunes-Silva ◽  
Eric Barret ◽  
Mohammed Baghdadi ◽  
Victor Srougi ◽  
Silvia Garcia Barreras ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Group Analysis ◽  
Focal Therapy ◽  
Primary Treatment ◽  
Matched Pair ◽  
Mri Findings ◽  
Predictive Values ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

e539 Background: Magnetic resonance imaging (MRI) plays an important role as a treatment-monitoring tool along focal therapy (FT) follow-up. This is the first study to assess MRI ability to correctly predict prostate cancer (PCa) local T-stage in the FT postoperative scenario. We aimed to describe MRI effectiveness in predicting upstaging in two groups of men: 1) men who failure after primary FT and then underwent salvage robotic-assisted radical prostatectomy (S-RARP) and 2) men who underwent RARP as primary treatment (P-RARP). Methods: Prospective data of 2775 men underwent RARP for localized PCa from 2000 to 2016 were reviewed. Twenty-two men underwent S-RARP after FT failure (S-RARP group). Total 2750 underwent RARP as first treatment. Matched-pair 1:2 selection of 44 out of 2750 patients by age defined primary RARP group (P-RARP). All patients underwent MRI immediately before RARP. MRI findings were confronted with final surgical pathology. Primary endpoint: sensitivity, specificity, positive and negative predictive values; positive (+LR) and negative (-LR) likelihood ratio regarding upstaging analysis on S-RARP. Secondary endpoint: same effectiveness analysis on P-RARP. Results: Preoperative MRI failed in predicting upstaging in 80% versus 91.7% of patients (p = 0.515) that presented final pathological status ≥ pT3a on S-RARP and P-RARP groups, respectively. On the other hand, when final pathology described a localized disease T2a-T2c, MRI correctly predicted the final pathological status in 81.8% versus 95.2% of patients (p = 0.27) on S-RARP and P-RARP groups, respectively. Between-group analysis, showed sensitivity and specificity rates of 20% versus 8.33% and 81.8% versus 95.23%, respectively; Positive and negative predictive values of 33.33% versus 50% and 69.23% versus 64.51%, respectively; Positive (+LR) and negative (-LR) likelihood ratio of 1.1 versus 1.74 and 0.98 versus 0.96, respectively. Conclusions: MRI has shown to be a weak diagnostic tool for predicting extra-prostatic disease along FT follow-up. Urologists may be warned about the risk of underdiagnosis and undertreatment in patients presenting failure after FT.

Diffusion-Weighted Magnetic Resonance Imaging of Cholesteatoma Using PROPELLER at 1.5T: A Single-Centre Retrospective Study

2017 ◽  
Vol 68 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Sharon E. Clarke ◽  
Dipan Mistry ◽  
Talal AlThubaiti ◽  
M. Naeem Khan ◽  
David Morris ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Retrospective Study ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Second Look ◽  
Diffusion Weighted ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Purpose The purpose of this study was to evaluate the sensitivity, specificity, and positive and negative predictive values of the diffusion-weighted periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique in the detection of cholesteatoma at our institution with surgical confirmation in all cases. Methods A retrospective review of 21 consecutive patients who underwent diffusion-weighted PROPELLER magnetic resonance imaging (MRI) on a 1.5T MRI scanner prior to primary or revision/second-look surgery for suspected cholesteatoma from 2009-2012 was performed. Results Diffusion-weighted PROPELLER had a sensitivity of 75%, specificity of 60%, positive predictive value of 86%, and negative predictive value of 43%. In the 15 patients for whom the presence or absence of cholesteatoma was correctly predicted, there were 2 cases where the reported locations of diffusion restriction did not correspond to the location of the cholesteatoma observed at surgery. Conclusion On the basis of our retrospective study, we conclude that diffusion-weighted PROPELLER MRI is not sufficiently accurate to replace second look surgery at our institution.

scholarly journals Inflammation and infiltration: can the radiologist draw a line? MRI versus CT to accurately assess medullary involvement in parosteal osteosarcoma

2020 ◽  
Vol 35 (1_suppl) ◽  
pp. 31-36 ◽  
Author(s):  
Maria Pilar Aparisi Gómez ◽  
Alberto Righi ◽  
Costantino Errani ◽  
Giancarlo Facchini ◽  
Marco Gambarotti ◽  
...  
Keyword(s):  
Predictive Value ◽  
Histological Analysis ◽  
High Sensitivity ◽  
Inflammatory Change ◽  
Parosteal Osteosarcoma ◽  
Predictive Values ◽  
Exact Test ◽  
Preserve Function ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Cancer causes inflammation as it progresses through healthy tissue. The differentiation of tumoral growth from the surrounding inflammatory change is paramount in planning surgeries seeking to preserve function. This retrospective study aims at illustrating how a careful use of imaging (computed tomography (CT)/magnetic resonance imaging (MRI)) can help to draw the line between infiltration and inflammation. Out of 72 cases of parosteal osteosarcoma in our institution we selected 22 which had pretreatment imaging, and out of those, 14 that had both MRI and CT. Using Fisher’s exact test, we evaluated the performance of each technique on accurately diagnosing medullary tumor infiltration, using histological analysis as a gold standard. All cases (14/14) demonstrated medullary abnormality on MRI, but only 6/14 (42.9%) demonstrated abnormality on CT. The 8/14 cases with MRI abnormality but no CT abnormality (57.1%) showed inflammation with no tumoral cells present on histological analysis. In the cases where the two examinations showed medullary abnormality (6/14) histology demonstrated tumoral infiltration. MRI demonstrated high sensitivity and negative predictive value, but low specificity and low positive predictive value and accuracy (P=1). CT demonstrated high sensitivity, specificity, high positive and negative predictive values and accuracy (P = 0.000333). MRI is highly sensitive for the detection of medullary abnormality but lacks specificity for tumor invasion. Correlation with CT is recommended in all cases of positive MR to add specificity for tumors. The adequate use of the two imaging methods allows to differentiate between inflammatory change and tumoral infiltration in POS, relevant for surgical planning.

Osteochondral Lesions of the Talus

2010 ◽  
Vol 100 (3) ◽  
pp. 189-194 ◽  
Author(s):  
Da-Peng Hao ◽  
Jian-Zhong Zhang ◽  
Zhen-Chang Wang ◽  
Wen-Jian Xu ◽  
Ji-Hua Liu ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Imaging Techniques ◽  
Three Dimensional ◽  
Cartilage Defects ◽  
Osteochondral Lesions ◽  
Talar Dome ◽  
Conventional Mri ◽  
Arthroscopic Findings ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Background: Conventional magnetic resonance imaging (MRI) has been demonstrated to be a valuable tool in diagnosing osteochondral lesions of the talus. No previous study, to our knowledge, has evaluated the diagnostic ability of fat-suppressed fast spoiled gradient-echo (FSPGR) MRI in osteochondral lesions of the talus. We sought to compare three-dimensional fat-suppressed FSPGR MRI with conventional MRI in diagnosing osteochondral lesions of the talus. Methods: Thirty-two consecutive patients with clinically suspected cartilage lesions undergoing three-dimensional fat-suppressed FSPGR MRI and conventional MRI were assessed. Sensitivity, specificity, and accuracy of diagnosis were determined using arthroscopic findings as the standard of reference for the different imaging techniques. The location of the lesion on the talar dome was recorded on a nine-zone anatomical grid on MRIs. Results: Arthroscopy revealed 21 patients with hyaline cartilage defects and 11 with normal ankle joints. The sensitivity, specificity, and accuracy of the two methods for detecting articular cartilage defect were 62%, 100%, and 75%, respectively, for conventional MRI and 91%, 100%, and 94% for three-dimensional fat-suppressed FSPGR MRI. Sensitivity and accuracy were significantly higher for FSPGR imaging than for conventional MRI (P &lt; .05), but there was no difference in specificity between these two methods. According to the nine-zone anatomical grid, the area most frequently involved was the middle of the medial talar dome (16 lesions, 76%). Conclusions: T1-weighted three-dimensional fat-suppressed FSPGR MRI is more sensitive than is conventional MRI in detecting defects of articular cartilage covering osteochondral lesions of the talus. (J Am Podiatr Med Assoc 100(3): 189–194, 2010)

Accessory Talar Facet Impingement and Sinus Tarsi Pain Associated With Accessory Anterolateral Talar Facet

2021 ◽  
pp. 107110072110021
Author(s):  
Jae Woo Park ◽  
JeongJin Park ◽  
Chul Hyun Park
Keyword(s):  
Bone Marrow Edema ◽  
Case Control Study ◽  
Case Control ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Sinus Tarsi ◽  
Magnetic Resonance Imaging Mri ◽  
And Gender ◽  
Calcaneal Cyst ◽  
Control Study

Background: Sinus tarsi pain caused by accessory talar facet impingement (ATFI) owing to accessory anterolateral talar facet (AALTF) is not well documented. We evaluated prevalence of AALTF and differences of magnetic resonance imaging (MRI) findings between persons with and without sinus tarsi pain, and investigated the relevant association between MRI findings and sinus tarsi pain in persons with AALTF. Methods: We performed a case-control study on 120 ankles with sinus tarsi pain and 120 age- and gender-matched ankles without sinus tarsi pain. As MRI findings, bone marrow edema (BME), sinus tarsi fat obliteration (STFO), calcaneal cyst, talocalcaneal coalition, Gissane angle, talar inferolateral surface (TILS) angle, and calcaneal cortical thickness (CCT) were evaluated. The MRI findings were compared between persons with and without sinus tarsi pain, and between persons with and without AALTF. Among persons with AALTF, MRI findings were compared between those with and without sinus tarsi pain. Relevant association was evaluated between MRI findings and sinus tarsi pain in persons with AALTF. Results: Presence of AALTF, BME, and STFO were significantly higher in the group with sinus tarsi pain. The Gissane angle was significantly smaller, and the TILS angle and CCT were significantly larger in the group with sinus tarsi pain. The BME (OR 7.571, CI 1.453-39.446) and small Gissane angle (OR 0.891, CI 0.804-0.986) were significantly associated with sinus tarsi pain in persons with the AALTF. Conclusion: The study provides evidence for ATFI related to impingement of an AALTF associated with talocalcaneal BME. Level of Evidence: Level III, case-control study.

scholarly journals LEVER SIGN TEST FOR CHRONIC ACL INJURY: A COMPARISON WITH LACHMAN AND ANTERIOR DRAWER TESTS

2021 ◽  
Vol 29 (3) ◽  
pp. 132-136
Author(s):  
MARCEL FARACO SOBRADO ◽  
MARCELO BATISTA BONADIO ◽  
GABRIEL FERNANDES RIBEIRO ◽  
PEDRO NOGUEIRA GIGLIO ◽  
CAMILO PARTEZANI HELITO ◽  
...  
Keyword(s):  
Predictive Value ◽  
Cruciate Ligament ◽  
Outpatient Setting ◽  
Sign Test ◽  
Level Of Evidence ◽  
Acl Injuries ◽  
Predictive Values ◽  
Anterior Drawer ◽  
Sensitivity Specificity ◽  
Different Levels

ABSTRACT Objective: This study aims to evaluate the sensitivity and specificity of the lever sign test in patients with and without chronic Anterior Cruciate Ligament (ACL) injuries in an outpatient setting and the inter-examiner agreement of surgeons with different levels of experience. Methods: 72 consecutive patients with a history of previous knee sprains were included. The Lachman, anterior drawer, and Lever Sign tests were performed for all subjects in a randomized order by three blinded raters with different levels of experience. Sensitivity, specificity, positive predictive value, negative predictive value, and inter-rater agreement were estimated for all tests. Results: Among the 72 patients, the prevalence of ACL injuries was 54%. The lever test showed sensitivity of 64.1% (95% CI 0.47-0.78) and specificity of 100% (95% CI 0.87-1.00) for the senior examiner. For the less experienced examiner the sensitivity was 51.8% and the specificity was 93.7%. Positive predictive values (PPV) and negative predictive values (NPV) were 100% and 70.2%, respectively. Conclusion: Lever Sign test shows to be a maneuver of easy execution, with 100% specificity and 100% PPV. Moderate agreement between experienced examiners and low agreement among experienced and inexperienced examiners was found. This test may play a role as an auxiliary maneuver. Level of Evidence I, Diagnostic Studies - Investigating a Diagnostic Test.

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