STUDY ON EFFICACY OF ULTRASOUND AND FOB IN CONFIRMING THE PLACEMENT OF LARYNGEAL MASK AIRWAY

2021 ◽  
pp. 48-49
Author(s):  
Ganga Nagalakshmi ◽  
Subha J.
Keyword(s):  
Test Performance ◽  
Predictive Value ◽  
Gold Standard ◽  
Linear Structure ◽  
Invasive Technique ◽  
Non Invasive ◽  
Optimal Depth ◽  
Correct Placement ◽  
Linear Probe ◽  
Standard Tool

Ultrasound is a safe and non invasive technique for assessing the airway . In this observational study, 60 patients belonging to ASAClasses I and II scheduled for elective general surgery without any airway abnormality were included. Squared wave of capnogramTransverse neck ultrasound was performed using linear probe (8- 13Hz) started from hyoid bone (hyperechoic supercial inverted Ushaped linear structure)probe moved caudally with slight cephalad angle visualization of vocal cord & arytenoids. The Ultrasound arytenoid grade had a signicant correlation with LMA rotation grade.The incidence of LMAMalposition by ultrasound was found to be 80% .With regard to the test performance ,US was found to have a sensitivity of 92%,with a positive predictive value of 94% to detect the LMA rotation of any number of degrees. The specicity was 62% with a negative predictive value of 55%. FOB Examination is the gold standard tool for conrmation of the correct placement of LMA. ,we evaluated USG as a tool to conrm the placement comparing with the FOB examinationThe FOB examination is invasive & interrupts the ventilation during procedure. It cannot be done frequently intra-operatively compromising ventilation. These problems can be overcome by using ultrasound.USG detects the rotation of LMAeven if it is positioned at optimal depth thereby predicting the chance of dislodgement during the course of surgery.

scholarly journals Diagnostic Accuracy of Doppler Ultrasound in the Diagnosis of Testicular Carcinoma by Taking Histopathology as Gold Standard

2021 ◽  
pp. 447-451
Author(s):  
Abid Ali Sahito ◽  
. Ahsanullah ◽  
Vicky Kumar ◽  
Mohsim Hussain ◽  
Humaira Ashraf ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Gold Standard ◽  
Cross Sectional Study ◽  
Radiology Department ◽  
Cross Sectional ◽  
Non Invasive ◽  
Testicular Carcinoma ◽  
Study Participants

Objective: To determine the diagnostic accuracy of doppler ultrasound in the diagnosis of testicular carcinoma, by taking histopathology as gold standard. Methods: This cross-sectional study was carried out at Radiology department of Liaquat University of Medical and health Sciences (LUMHS), from November 2017 to October 2019. All the clinically diagnosed cases of testicular carcinoma, those who referred for doppler ultrasound and histopathology of testes, were included. After taking informed consent all the study participants underwent testicular histopathology after doppler ultrasound. All of the information was entered into a research proforma. SPSS version 20 was used to analyze the data. Results: Overall, 70 patients of suspected testicular carcinoma were studied. The mean age of the cases was 38.38+4.55 years. Most of the cases 47(67.1%) were poor. As per Doppler ultrasound (U/S) findings out of all 55.7% cases had diagnosed testicular carcinoma, while histopathologically it was observed in 45.7% of the cases. Diagnostic accuracy of Doppler U/S in testicular carcinoma diagnosis was observed to be 77%, followed by sensitivity (SE) 84%, specificity (SP) 71%, positive predictive value (PPV) 78% and negative predictive value (NPV) 84%. Conclusion: Doppler ultrasound observed to be a non-invasive, uncomplicated, lack of pain, effective and easily available diagnostic tool for early diagnosis of testicular carcinoma.

scholarly journals Diagnostic accuracy of ultrasound in detection of pregnancy associated breast cancer

2021 ◽  
Vol 4 (1) ◽  
pp. 3-8
Author(s):  
Zainab Mehmood ◽  
Rafia Shahzad ◽  
Ismat Fatima ◽  
Abubaker Shahid
Keyword(s):  
Breast Cancer ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Linear Probe

Introduction: Some unique physiological changes occur in breast volume and water content during pregnancy which makes the radiological evaluation of the breast difficult.  As a result, diagnosis of Pregnancy Associated Breast Cancer.  is often delayed. Objective: To find out the diagnostic accuracy of ultrasonography in detection of pregnancy associated breast cancer taking histopathology as gold standard. Methodology: Present Cross-sectional study was carried out at INMOL Hospital, Lahore. Ultrasound of 200 women was performed. The patient was laid supine and then turned slightly in oblique position to scan the breast with high frequency linear probe (7.5-10 MHz). The contra-lateral breast and both axillae were also scanned in the same way. Findings were categorized on the basis of Breast Imaging Reporting and Data System (BI-RADS) assessment categories. Subsequently the breast tissue was sent to histopathology laboratory for tissue diagnosis. The pathologist was blinded of the results of ultrasonography. Results: Mean age was 34 ± 11.36 years. Twenty-eight percent patients were primi-para while 72% patients were multi-para. Diagnostic accuracy of ultrasonography taking histopathology as gold standard was analyzed and ultrasonography had sensitivity 84.78%, specificity 98.05%, positive predictive value 92.85%, negative predictive value 95.56% and diagnostic accuracy was 95%. Invasive ductal carcinoma was most commonly observed (P<0.001) malignant histopathology. On the other hand, significantly high (P = 0.033) number of benign lesions were Fibroadenomas. Conclusion: The high sensitivity and specificity along with easy availability, and non-invasive nature makes ultrasonography a very useful technique for the diagnosis of Pregnancy Associated Breast Cancer.

scholarly journals Positive Predictive Value of MRI in the Diagnosis of Intra-Abdominal Undescended Testes Taking Laparoscopic Findings as Gold Standard

2021 ◽  
Vol 15 (1) ◽  
pp. 36-39
Author(s):  
Aasia Jehangir ◽  
◽  
Amber Goraya ◽  
Abid Ali Qureshi ◽  
◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
Gold Standard ◽  
Vital Role ◽  
True Positive ◽  
Undescended Testes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Non Invasive

Background: Cryptorchidism also known as undescended testis, is a birth defect in male babies with higher frequency in preterm infants, leading infertility and other genital problems. In its treatment, diagnosis has a vital role. Objective: The objective of this study was to determine the positive predictive value of MRI in the diagnosis of intra-abdominal undescended testes taking laparoscopic findings as gold standard. Study Design: It was a cross-sectional survey. Settings: Research was conducted at Department of Diagnostic Radiology, Children Hospital & Institute of Child Health Lahore Pakistan. Duration: Six months from June 23, 2018 to December 22, 2018. Methodology: This study involved 68 boys aged between 2 to 15 years presenting with undescended testes. Intra-abdominal undescended testes were diagnosed on MRI and was later confirmed on laparoscopic findings which were taken as gold standard and diagnosis of MRI was judged accordingly as true positive or false positive. A written informed consent was obtained from parents of every patient. Results: The age of the children ranged from 2 years to 15 years with a mean of 8.1±3.5 years. Majority (n=53, 77.9%) of the children had right while 15 (22.1%) children had left undescended testes. Diagnosis of intra-abdominal testes was confirmed in 64 (94.1%) patients on laparoscopy. Thus, there were 64 true positive and 4 false positive cases. It yielded a positive predictive value of 94.1% for MRI in predicting intra-abdominal undescended testes taking laparoscopy as gold standard. Similar positive predictive value was noted across various age and anatomical side groups. Conclusion: The positive predictive value of MRI was found to be 94.1% in predicting intra-abdominal undescended testes taking laparoscopic findings as gold standard regardless of patient’s age and anatomical side which along with its non-invasive and radiation free nature advocates its preferred use in future practice.

scholarly journals Coronary computed tomography versus coronary angiography for preoperative coronary assessment before valve surgery

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Abdalla Elagha ◽  
Waleed Khaled ◽  
Sahar Gamal ◽  
Mohamed Helmy ◽  
Ayman Kaddah
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Negative Predictive Value ◽  
Coronary Arteries ◽  
Predictive Value ◽  
Gold Standard ◽  
Valve Surgery ◽  
Invasive Technique ◽  
Coronary Computed Tomography ◽  
Study Population

Abstract Background Conventional coronary angiography (CAG) is currently the gold standard technique for the assessment of coronary arteries prior to cardiac valve surgery. Although CAG is a relatively safe procedure, however, it is still an invasive procedure, and it has potential hazards and complications. Coronary computed tomography angiography (CCTA) is a non-invasive technique that has emerged robustly as an excellent and attractive tool for delineating coronary anatomy. Therefore, we sought to evaluate the accuracy of CCTA when compared with the gold standard CAG in the evaluation of coronary arteries before valve surgery. We screened 111 consecutive patients with VHD undergoing a routine cardiac catheterization for preoperative evaluation of CAD. Fifty patients were eligible and underwent both CAG and CCTA. Significant coronary stenosis was defined as a luminal diameter decrease of ≥ 50%. Additionally, ectasia, calcifications, and congenital coronary anomalies were analyzed. Also, we compared both techniques regarding radiation dose, contrast volume, and complications. Non-evaluable segments were excluded from all levels of analysis. Sixty-one patients were excluded from the study due to various reasons. Results Among the 50 patients of the study population, 27 (54%) were males. The prevalence of significant CAD in the study population was 19.6% according to the patient-based analysis, and CAG could have been avoided in 80.4% of patients with a true-negative CCTA result. Diagnostic accuracy of CCTA for detection of significant stenosis was evaluated regarding sensitivity and specificity, positive predictive value, negative predictive value, and overall accuracy of CCTA, which was 87.5%, 99.6%,87.5%, 99.6%, and 99.2%, respectively, for segmental-based analysis; 86%, 100%, 100%, 99%, and 99%, respectively, for vessel-based analysis; and 77.8%,100%,100%, 94.9%, and 95.7%, respectively, for patient-based analysis. Fewer rates of complications were encountered with CCTA. Additional information obtained like calcifications and congenital anomalies was diagnosed better with CCTA than CAG. Conclusion Owing mainly to its high negative predictive value, a well-performed CCTA exam is an excellent method to rule out coronary artery disease, specially in patients who are not at high risk of atherosclerosis.

Diagnosis of Deep Vein Thrombosis by Combination of Doppler Ultrasound Flow Examination and Strain Gauge Plethysmography

1982 ◽  
Vol 47 (02) ◽  
pp. 141-144 ◽  
Author(s):  
H Bounameaux ◽  
B Krähenbühl ◽  
S Vukanovic
Keyword(s):  
Deep Vein Thrombosis ◽  
Negative Predictive Value ◽  
Doppler Ultrasound ◽  
Strain Gauge ◽  
Predictive Value ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Strain Gauge Plethysmography ◽  
Deep Vein

SummaryDoppler ultrasound flow examination, strain gauge plethysmography and contrast venography were performed in 160 lower limbs of 80 in-patients. Deep vein thrombosis (DVT) was suspected in 87 limbs. Using measurement of venous stop-flow pressure, the Doppler method had an overall sensitivity of 83%. By combined use of Doppler and Plethysmography, sensitivity was increased to 96%. Specificity was 62% and 51%, respectively. With a positive and a negative predictive value of 80% and 73%, respectively, the combination of both non-invasive methods cannot reliably replace venography in the diagnosis of DTV, although all (40/40) thromboses proximal to or involving the popliteal segment were detected by either Doppler and Plethysmography or both.After exclusion of 14 patients (18%) suffering from conditions known to alter the results of these non-invasive methods, the positive predictive value of abnormal findings in both Doppler and Plethysmography was increased to 94% for suspected limbs, whilst negative predictive value of both negative Doppler and Plethysmography was 90%, allowing the avoidance of venography in these patients.

Noninvasive Assessment of Liver Diseases using 2D Shear Wave Elastography

2016 ◽  
Vol 25 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Monica Lupșor-Platon ◽  
Radu Badea ◽  
Mirela Gersak ◽  
Anca Maniu ◽  
Ioana Rusu ◽  
...  
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Liver Diseases ◽  
Venous Pressure ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Two Dimensional ◽  
Non Invasive ◽  
Examination Technique

There has been great interest in the development of non-invasive techniques for the diagnosis of liver fibrosis in chronic liver diseases, including ultrasound elastographic methods. Some of these methods have already been adequately studied for the non-invasive assessment of diffuse liver diseases. Others, however, such as two-dimensional Shear Wave Elastography (SWE), of more recent appearance, have yet to be validated and some aspects are for the moment incompletely elucidated. This review discusses some of the aspects related to two-dimensional SWE: the examination technique, the examination performance indicators, intra and interobserver agreement and clinical applications. Recommendations for a high-quality examination technique are formulated. Key words:  –  –  – Two-dimensional Shear Wave Elastography. Abbreviations: 2D- SWE: Two-dimensional Shear Wave Elastography; 3D- SWE: Three-dimensional Shear Wave Elastography; AUROC: area under the receiver operating characteristic curves; ARFI Acoustic Radiation Force Impulse Elastography; EFSUMB: European Federation of Societies for Ultrasound in Medicine and Biology; HVPG: hepatic venous pressure gradient; LS: liver stiffness; LR: likelihood ratio; NPV: negative predictive value; PPV: positive predictive value; ROI: region of interest; RT-E: Real Time-Elastography; Se: sensitivity; Sp: specificity; TE: Transient Elastography; US: ultrasound; VM: valid measurement; E: Young’s modulus

USING DOPPLER TO ASSESS THE FETAL HEALTH FOR THE PREDICTION OF GESTATIONAL OUTCOME

2014 ◽  
pp. 9-18
Author(s):  
Thi Linh Giang Truong ◽  
Vu Quoc Huy Nguyen
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Functional Method ◽  
Invasive Technique ◽  
Routine Practice ◽  
Fetal Health ◽  
Uterine Arteries ◽  
Non Invasive ◽  
Key Words Doppler

Background: Assessment of fetal health plays the most important role in prenatal care because of influence of the prediction of gestational outcome. One of the main aims of routine antenatal care is to identify the ‘ at risk ‘ fetus in order to apply clinical interventions which could results in reduced perinatal morbidity and mortality. Doppler ultrasound is a non invasive technique whereby the movement of blood is studied by detecting the change in frequence of reflected sound, Doppler blood flow velocity waves form of fetal side (umbilical artery, middle cerebral artery ...) and maternal side ( uterine arteries) are discussed and monograms for routine practice are presented. Recently this method is important tool for qualifying high risk pregnancies and help early forecasts the health of the babies and mothers disorder. Doppler sonography in obstetrics is a widely accepted functional method of examining the prediction of gestational outcome. Key words: Doppler, umbilical artery, middle cerebral artery, uterine arteries

Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Pleural Effusions ◽  
Diagnostic Efficacy ◽  
Chest Sonography ◽  
X Ray ◽  
Non Invasive ◽  
Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

scholarly journals Efficiency of non-invasive prenatal screening in pregnant women at advanced maternal age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Zhu ◽  
Xiaoxiao Jin ◽  
Yuqing Xu ◽  
Weihua Zhang ◽  
Xiaodan Liu ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Predictive Value ◽  
Trisomy 21 ◽  
Maternal Age ◽  
Prenatal Screening ◽  
Advanced Maternal Age ◽  
Youden Index ◽  
Non Invasive ◽  
Sensitivity Specificity

Abstract Background Non-invasive prenatal screening (NIPS) is widely used as the alternative choice for pregnant women at high-risk of fetal aneuploidy. However, whether NIPS has a good detective efficiency for pregnant women at advanced maternal age (AMA) has not been fully studied especially in Chinese women. Methods Twenty-nine thousand three hundred forty-three pregnant women at AMA with singleton pregnancy who received NIPS and followed-up were recruited. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), receiver operating characteristic (ROC) curves and the Youden Index for detecting fetal chromosomal aneuploidies were analyzed. The relationship between maternal age and common fetal chromosomal aneuploidy was observed. Results The sensitivity, specificity, PPV, NPV of NIPS for detecting fetal trisomy 21 were 99.11, 99.96, 90.98, and 100%, respectively. These same parameters for detecting fetal trisomy 18 were 100, 99.94, 67.92, and 100%, respectively. Finally, these parameters for detecting trisomy 13 were 100, 99.96, 27.78, and 100%, respectively. The prevalence of fetal trisomy 21 increased exponentially with maternal age. The high-risk percentage incidence rate of fetal trisomy 21 was significantly higher in the pregnant women at 37 years old or above than that in pregnant women at 35 to 37 years old. (Youden index = 37). Conclusion It is indicated that NIPS is an effective prenatal screening method for pregnant women at AMA.

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