scholarly journals Diagnostic Accuracy of Different Computed Tomography Signs for Differentiating Between Malignant and Cirrhotic Ascites Keeping Ascitic Fluid Cytology as Gold Standard

Cureus ◽  
2021 ◽  
Author(s):  
Ibtesam Zafar ◽  
Ayesha Isani Majeed ◽  
Muhammad Waseem Asad ◽  
Amir Khan ◽  
Muzammil Rasheed Bhutta ◽  
...  
2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19


2021 ◽  
Vol 15 (8) ◽  
pp. 2500-2501
Author(s):  
Aliya Khan ◽  
Abid Ali Sahito ◽  
Mahreen Shaikh ◽  
Humera Jabeen ◽  
Humaira Ashraf ◽  
...  

Objective: To evaluate the diagnostic accuracy of multislice computed tomography (CT) in detection of squamous cell carcinoma (SCC) of oral cavity in clinically suspected patients taking histopathology as gold standard. Material and Methods: This cross-sectional study has been conducted at Radiology department of Civil Hospital Karachi from 8th September 2018 to March 2019. All the cases having suspected oral squamous cell carcinoma and either of gender were included. Patients underwent computed tomography by using multislice scanner. Then patients undergone biopsy sampling and patients were labeled as positive or negative for squamous cell carcinoma of oral cavity on MDCT and histopathology. Sensitivity, specificity, and diagnostic accuracy of multislice CT for squamous cell carcinoma of oral cavity were measured taking histopathology as gold standard. Results: Total 168 cases were studied and out of them males were 76.8% and females were 23.2%. Mean gutka addiction history was 11.52±5.21 years. Mean lesion size on CT scan was 2.44±1.43 cm. In our study, 35.1% patients were diagnosed positive by multislice computed tomography and 43.5% through histopathology. Sensitivity, Specificity, PPV, NPV and accuracy were 86.4%, 79.8%, 69.9%, 91.6%, and 82.1% respectively. Conclusion: Multislice CT observed to be the effective diagnostic tool for the detection of SCC of oral cavity. Keywords: Multislice Computed Tomography, cancer, Oral Cavity


2021 ◽  
Vol 7 (9) ◽  
pp. 323-330
Author(s):  
M. Smanaliev ◽  
G. Yuldasheva ◽  
I. Yuldashev

After determining the need for complex types of restoration of chewing efficiency, which amounted to 22% of the total number of prosthetics performed in dental clinics in Bishkek, Kyrgyzstan, the optimal modern clinical and diagnostic methods that can be used according to the experience of the Biodent clinic, Bishkek were summarized. Cone-beam computed tomography recognized as the gold standard for radiological examination and modeling of dental implantation. The diagnostic accuracy was 99.2% versus 70.5% with orthopantomography. Treatment of the surface of dental titanium implants with nano-solutions of gold and silver, which have antiseptic and engraftment-improving properties in the clinic, leads to an improvement in the results of engraftment and functioning, confirmed by biochemical studies.


2017 ◽  
Vol 51 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Harun Arslan ◽  
Mehmet Fatih Özbay ◽  
İskan Çallı ◽  
Erkan Doğan ◽  
Sebahattin Çelik ◽  
...  

Abstract Background Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared. Patients and methods We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm2) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used. Results Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%. Conclusions The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy.


Author(s):  
Hina Pathan ◽  
M. Kashif Shazlee ◽  
Junaid Iqbal ◽  
Ashraf A. Ali ◽  
Kamran Hameed ◽  
...  

Background: Ultrasonography is a useful modality to diagnose stones and to confirm the occurrence of complications of other renal pathology, so it is important to understand these characteristic findings and other diseases that mimic them. In addition, other imaging modalities such as computed tomography (CT) can be recommended if the clinical or radiological diagnosis is ambiguous.Methods: A group of 325 patients with clinical suspicion of renal calculi were included in this study. Out of these 325 patients 179 (55.0%) were male and 146 (44.9%) were female. All these patients underwent ultrasonography (USG) examination. Final diagnosis was based on CT findings which was done subsequently.Results: The total number of patients comprising the study were 325 who underwent ultrasound examination. After USG and CT scan was done to confirm the diagnosis. Out of 325 patients, 201 patients were confirmed having renal calculi on USG analysis and remaining 103 patients were true negative.Conclusions: The study proves that USG is highly accurate in diagnosing and characterizing renal calculi. USG also guides in defining exact location as well as aids in deciding the medical or surgical approach to be used.


2021 ◽  
Vol 15 (11) ◽  
pp. 3164-3165
Author(s):  
Mohammad Iltaf ◽  
Sana Akhtar ◽  
Dilaram Khan

Objective: To establish the diagnostic accuracy of BISAP in detecting the severe acute pancreatitis keeping computed tomography severity index as gold standard. Study Design: Cross-sectional study Place and Duration of Study: Department of Gastroenterology, Hayatabad Medical Complex, Peshawar from April 16th 2018 to 16th October 2018. Methodology: One hundred and twenty nine patients of age range of 18-60, of either gender having severe acute pancreatitis were included. While patients already diagnosed as severe acute pancreatitis and having known history of chronic pancreatitis were excluded. Patients were subjected to CT scan to confirm whether the severe acute pancreatitis is present or not. All CT scans were reported by single experiences radiologist. Results: There were 30.3% were males and 69.7% were females with mean age 42±11.03 years. BISAP had sensitivity 92.74%, specificity 80%, positive predictive value 99.13%, negative predictive value 20.76% and the overall diagnostic accuracy was 92.24%. Conclusion: BISAP had sensitivity 93.61%, specificity 100%, positive predictive value 100%, negative predictive value 40% and the overall diagnostic accuracy was 93.87% in severe acute pancreatitis keeping CT severity index as gold standard. Keywords: Accuracy, Severe acute pancreatitis, Computed tomography


Author(s):  
Ashraf Amirali ◽  
Jaideep Darira ◽  
Hina Pathan ◽  
Sorath Murtaza ◽  
Munaza Irshad

The aim of the study is the assessment of accuracy for the diagnostic evaluation of Wilms tumor in the pediatric population in the era of contrast-enhanced CT scan using histopathology as a gold standard. Plain and contrast-enhanced abdominal Computed Tomography including pelvis and chest was performed in suspected patients with multiple axial sections with sagittal and coronal reconstructions. Patients were being followed, data was collected and recorded on proforma after histopathology. The patient's mean age for this study in years was 3.5 ± 1.2. Gender distribution showed 170 patients (54.6%) were male while the remaining 141 patients (45.33%) were female. Contrast-enhanced computed tomography showed sensitivity (90.36%), specificity (51.72%), diagnostic accuracy (72.34%), positive predictive value (68.18%), and negative predictive value (82.42%) confirmed on Histopathology as the gold standard. It is concluded from the results of this study that contrast-enhanced computed tomography proved high diagnostic accuracy positive predictive in the detection of Wilms’ tumor by taking histopathology as the gold standard.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Baumann ◽  
M Hirt ◽  
U J Schoepf ◽  
M Renker ◽  
S J Buss ◽  
...  

Abstract Background Based on coronary computed tomography angiography (cCTA), stenoses can be detected but provides anatomical assessment solely. Fractional flow reserve based on coronary CT angiography (ML-cFFR) is gaining in importance for non-invasive hemodynamic assessment of obstructive coronary artery disease (CAD), as several large trials demonstrated significantly improvements in diagnostic accuracy to cCTA. Comparably instantaneous wave free ratio (iFR) is a novel resting index for the invasive determination of haemodynamic relevant stenoses, finds consideration in the ESC guideline on myocardial revascularization and is now of equal standing with FFR as a class IA recommendation. Purpose The aim of our study was to evaluate the on-site ML-cFFR in terms of diagnostic accuracy and clinical practicability in comparison to the iFR as the current invasive gold standard to detect hemodynamically significant coronary artery stenoses. Methods In our prospective, multi-center study, patients with CAD who had a clinically indicated cCTA and subsequent invasive coronary angiography with iFR-measurement were included. To analyse the acquired cCTA dataset we used a third-generation dual-source CT with on-site prototype ML-cFFR software that is based on a machine-learning algorithm, to determine the hemodynamic relevance of coronary stenoses. Results Between July 2017 and December 2018, in 40 of 42 cases (95%), the on-site ML-cFFR calculation was successful. Finally we enrolled 40 patients (72.5% males, mean age 66.7±11.9 years) with ML-cFFR calculation based on cCTA and iFR-measurement during ICA. The mean calculation time of the ML-cFFR values was 10.6±1.9minutes. 57 vessel specific lesions were analysed, of which 15 (26%) were determined as hemodynamically relevant stenoses by iFR (iFR≤0.89) whereas ML-cFFR classified only 14 (24.5%) as hemodynamic significant coronary stenoses (ML-cFFR≤0.80). We observed that cCTA overestimated the severity of stenoses in 27 of 40 cases, which might lead to unnecessary coronary angiographies. However, ML-cFFR detected no obstructive CAD in 26 of 40 patients (65%) and this would have resulted in a reduction of initially performed pure diagnostic coronary angiography. Estimated values sensitivity, specificity, PPV and NPV were 86.7%, 97.4%, 92.9% and 95.0%. The diagnostic accuracy of ML-cFFR in terms of iFR on a per-patient and per-lesion level was 95.0% and 96.5%. The area under the curve (AUC) on a per-lesion and per-patient basis by ML-cFFR to detect lesion specific ischemia was 0.97 and 0.96. The analysis of the correlation (Pearson's product-moment) on a per-lesion level was r=0.82 (p<0.0001) between the ML-cFFR algorithm and iFR. Conclusion(s) On-site ML-cFFR correlates excellently with the novel gold standard iFR to non-invasively detect hemodynamic significant coronary stenoses in routine clinical practice. Acknowledgement/Funding Doctor S. Baumann receives research support from Siemens and Philips Volcano. All other authors declare that they have no financial disclosure.


2018 ◽  
Vol 25 (04) ◽  
pp. 589-593
Author(s):  
Umme Aeman Khan ◽  
Hamna Iqbal ◽  
Muhammad Omer Aslam ◽  
Muhammad Ehtisham Saqib ◽  
Hafiz M. Yassen ◽  
...  

Objectives: To find out the diagnostic accuracy of ascitic fluid LactateDehydrogenase in diagnosis of Spontaneous bacterial peritonitis using ascitic fluid absoluteneutrophil count equal to or greater than 250 cells/mm3 as a Gold Standard. Study Design:Cross sectional (validation) study. Setting: This study was conducted in department ofMedicine, Madina Teaching Hospital Faisalabad. Duration of Study: 6 months starting afterapproval of synopsis (From:01-06-2016 to 30-11-16). Methodology: 10 ml of ascitic fluidwas withdrawn from these patients, and sent for cytology and biochemistry. Ascitic fluid cellcount, total protein, albumin and LDH wascalculated along with serum albumin and serumLDH. Serum LDH and ascitic fluid LDH was calculated by using Cobas C311 Roche Analyzer,serum/ascitic albumin gradient (SAAG) was calculated by subtracting ascitic albumin fromserum albumin to prove portal hypertension as a cause of ascites. AsciticLDH/serum LDH ratiowas calculated by dividing ascitic LDH by serum LDH.Absolute neutrophil count was derivedfrom total WBC count. Results: In our study, mean age was calculated as 45.37+11.13 years,53.75% (n=43) were male and 46.25% (n=37) were females. Frequency SBP on gold standardwas recorded in 52.5% (n=42). Diagnostic accuracy of ascitic fluid lactate dehydrogenasein diagnosis of spontaneous bacterial peritonitis using ascitic fluid absolute neutrophil countequal to or greater than 250 cells/mm3 as a gold standard was recorded as 82.22%, 85.71%,88.09%, 78.95%, 83.75% for sensitivity, specificity, positive predictive value, negative predictivevalue and accuracy rate, positive likelihood ratio was calculated as 5.75 and 0.21 for negativelikelihood ratio was calculated as 5.75. Conclusion: The diagnostic accuracy of ascitic fluidLactate Dehydrogenase is higher in diagnosis of Spontaneous bacterial peritonitis using asciticfluid absolute neutrophil count equal to or greater than 250 cells/mm3 as a Gold Standard.


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