Accuracy Of Abdominal Ultrasonography Research Articles

Preoperative serum C-reactive protein concentration can be used to detect gallbladder rupture in dogs with gallbladder mucocele.

To determine whether serum C-reactive protein (CRP) concentration could be used to detect gallbladder rupture (GBR) prior to surgery in dogs undergoing cholecystectomy for treatment of gallbladder mucocele (GBM). 45 dogs that underwent cholecystectomy because of GBM at a companion animal referral hospital from 2017 to 2020. Electronic medical records were reviewed, and dogs were included if serum CRP concentration had been measured within 24 hours prior to cholecystectomy. Dogs were grouped as to whether the gallbladder was found to be ruptured or intact during surgery. Accuracy of using preoperative CRP concentration to predict GBR was compared with accuracy of abdominal ultrasonography and other preoperative blood tests. GBR was present in 15 dogs at the time of surgery. Median preoperative CRP concentration was significantly higher in dogs with GBR (15.1 mg/dL; interquartile range, 7.4 to 16.8 mg/dL) than in dogs with an intact gallbladder (2.65 mg/dL; interquartile range, 0.97 to 13.4 mg/dL). Sensitivity, specificity, and accuracy of using preoperative CRP concentration to predict GBR were 100%, 67%, and 78%, respectively. Measurement of preoperative CRP concentration provided excellent sensitivity and moderate specificity for detection of GBR in dogs undergoing cholecystectomy because of GBM. Accuracy of using preoperative CRP concentration for detection of GBR was not superior to the accuracy of preoperative abdominal ultrasonography. However, when CRP concentration was combined with results of ultrasonography, the sensitivity, specificity, and accuracy for detection of GBR were 100%, 93%, and 96%, respectively.

Diagnostic Accuracy of Abdominal Ultrasonography for Intussusception in Children: A Systematic Review and Meta-analysis

Purpose Intussusception is an abdominal emergency commonly encountered by emergency department (ED) and primary care clinicians. Diagnosis of intussusception can be challenging based on medical history and physical examination, and were traditionally confirmed by surgery, diagnostic ultrasound or fluoroscopy. There is growing evidence to suggest that point-of-care ultrasonography (POCUS) of the abdomen appears to be a reliable diagnostic modality for childhood intussusception. We conducted a meta-analysis to summarize current evidence on …

FAST and abnormal urinalysis: the effective screening tools in pediatric abdominal trauma

Objective: The present study examines the diagnostic accuracy of abdominal ultrasonography and urinalysis test in children with blunt abdominal trauma, compared with CT scan. The aim of this study was to compare the diagnostic value of ultrasound and urinalysis test with CT scan as a golden standard diagnostic method in predicting abdominal peritoneal injury in these patients. Methods: This prospective study, based on diagnostic accuracy evaluation, was performed on children with blunt abdominal traumas less than 12 years of age who were referred to the emergency department from 2017-2018 and for whom abdominal ultrasonography, urinalysis and abdominal CT scans were requested. Demographic data, mechanism of trauma, the results of urine tests, ultrasound and CT scan of the abdomen were recorded. Sensitivity, specificity, positive and negative predictive values were used to measure the diagnostic power of the tests. Results: In this study, 100 children with multiple traumas were included. The mean age of these patients was 5.75 ± 3 years with a range of 1-12 years. In terms of sexual distribution, 69 (69%) were boys and 31 (31%) were girls. According to the results, ultrasound with an abnormal urinalysis test had sensitivity of 85.7%, specificity of 91.9%, positive predictive value of 63.2% and negative predictive value of 97.5%. The accuracy was 91%. Conclusion: According to the results of this study, the combination of ultrasonography and urinalysis resulted in a significant increase in diagnostic value (P <0.001). Pediatric patients with a negative ultrasonography and urinalysis test should be observed rather than subjected to the radiation risk of CT

Sensitivity and Specificity of Ultrasonographic Evaluation of Small Intestine Wall Thickness in the Diagnosis of Inflammatory Bowel Disease in Horses: a Retrospective Study

In horses, inflammatory bowel disease (IBD) usually determines a chronic wasting syndrome (CWS) which is a highly nonspecific clinical syndrome; therefore, diagnosing IBD often represents a challenge. Little is known about the accuracy of abdominal ultrasonography in horses suspected of IBD: previous studies reported abdominal ultrasonography to be useful in the diagnostic approach for IBD in the equine patient but, to the authors' knowledge, no studies assessed its accuracy. The aim of the present study was to assess sensitivity and specificity of ultrasonographic measurement of small intestine wall thickness in the diagnosis of IBD, using rectal biopsy as a reference standard. Thirty-five horses presented for CWS were retrospectively selected among a clinical population. Assessment of sensitivity, specificity, and receiving operator characteristics curve elaboration were made initially for all the patient population and then repeated including only those horses showing ultrasonographic evidence of diffuse small intestinal wall thickening. When all patients were considered, a 5.7 mm cutoff value was the best compromise between sensitivity (36.8%) and specificity (87.5%). When only those patients with diffuse thickening were considered, a 5 mm cutoff value was the best compromise between sensitivity (50%) and specificity (100%). According to the results obtained, ultrasonography appears to be a specific method for the evaluation of small intestinal wall thickness, and it could be useful in the diagnostic protocol of IBD in horses with CWS.

Accuracy of abdominal ultrasound for the diagnosis of pneumoperitoneum in patients with acute abdominal pain: a pilot study.

BackgroundPneumoperitoneum is a rare cause of abdominal pain characterized by a high mortality. Ultrasonography (US) can detect free intraperitoneal air; however, its accuracy remains unclear. The aims of this pilot study were to define the diagnostic performance and the reliability of abdominal US for the diagnosis of pneumoperitoneum.MethodsThis was a prospective observational study. Four senior and two junior physicians were shown, in an unpaired randomized order, abdominal US videos from 11 patients with and 11 patients without pneumoperitoneum. Abdominal US videos were obtained from consecutive patients presenting to ED complaining abdominal pain with the diagnosis of pneumoperitoneum established by CT. Abdominal US was performed according to a standardized protocol that included the following scans: epigastrium, right and left hypochondrium, umbilical area and right hypochondrium with the patient lying on the left flank. We evaluated accuracy, intra- and inter-observer agreement of abdominal US when reviewed by senior physicians. Furthermore, we compared the accuracy of a “2 scan-fast exam” (epigastrium and right hypochondrium) vs the full US examination and the accuracy of physicians expert in US vs nonexpert ones. Finally, accuracy of US was compared with abdominal radiography in patients with available images.ResultsConsidering senior revision, accuracy of abdominal US was 88.6 % (95 % CI 79.4-92.4 %) with a sensitivity of 95.5 % (95 % CI 86.3–99.2 %) and a specificity of 81.8 % (95 % CI 72.6–85.5 %). Inter- and intra-observer agreement (k) were 0.64 and 0.95, respectively. Accuracy of a “2 scan-fast exam” (87.5 %, 95 % CI 77.9–92.4 %) was similar to global exam. Sensitivity of abdominal radiography (72.2 %, 95 % CI 54.8–85.7 %) was lower than that of abdominal US, while specificity (92.5 %, 95 % CI 79.5–98.3 %) was higher. Accuracy (68.2 %, 95 % CI 51.4–80.9 %) of junior reviewers evaluating US was lower than senior reviewers.ConclusionsSenior physicians can recognize US signs of pneumoperitoneum with a good accuracy and reliability; sensitivity of US could be superior to abdominal radiography and a 2 fast-scan exam seems as accurate as full abdominal examination. US could be a useful bedside screening test for pneumoperitoneum.Trial registry ClinicalTrials.gov; No.: NCT02004925; URL: http://www.clinicaltrials.govElectronic supplementary materialThe online version of this article (doi:10.1186/s13089-015-0032-6) contains supplementary material, which is available to authorized users.

Differential diagnosis of infantile choledochal cyst with or without biliary atresia.

The choledochal cyst, a cystic dilatation of the biliary tree, in infancy may be associated with biliary atresia (BACH) or without biliary atresia (CH). Infants in both groups usually have similar clinical symptoms at presentation but different management and prognosis. We retrospectively identified 29 infants, aged younger than 1 year, who had surgically proven choledochal cysts from 1991 to 2004. They were diagnosed as CH in 18 patients and BACH in eleven. They had undergone preoperative abdominal ultrasonography (29 patients) and intravenous radionuclide cholangiography (IVRC) (19 patients). The comparison of the clinical characteristics and laboratory examinations between the two groups showed that BACH patients had no sex predominance contrasting to female predominance in CH patients, more often presented with prolonged jaundice and clay-colored stool, and had higher bilirubin levels. In diagnosing BACH by ultrasonography, using the diameter of the extrahepatic cystic dilatation < or =1.5 cm but not atretic gallbladder further increased the sensitivity, specificity, positive and negative predictive rates (81.8%, 100%, 100%, 90% vs 54.5%, 88.8%, 75%, 76.2%, respectively), yielding an increased diagnostic accuracy (93.1% and 75.9%, respectively). In diagnosing BACH by IVRC, the sensitivity, specificity, positive and negative predictive value and diagnostic acCuracy were 100%, 70%, 75%, 100% and 84.2%, respectively. We concluded that there were clinical and laboratory discrepancies between the two groups, including female predominance, prolonged jaundice, clay-colored stool, bilirubin levels and size of cyst. In diagnosing BACH, the accuracy of abdominal ultrasonography will be increased if we use the diameter of the extrahepatic cystic dilatation < or = l.5 cm but not atretic gallbladder as one of the diagnostic cretia. Hepatobiliary scintigraphy had less diagnostic accuracy than ultrasonography but can be added to exclude the diagnosis of BACH.

Abdominal ultrasonography in the diagnosis of colonic cancer.

Colonic cancer is normally diagnosed by barium enema or colonoscopy. Neither investigation is ideal, especially in the elderly patient. This study investigates the potential role of abdominal ultrasonography in the diagnosis of colorectal carcinoma. Fifty-four patients with known or suspected colonic carcinoma were referred for abdominal ultrasonography. A single radiologist performed scans on these patients and the site of any colonic mass or wall thickening considered to be consistent with a colonic carcinoma was reported. All carcinomas were confirmed by histology on tissue obtained at colonoscopy or surgery against which the ultrasonographic diagnosis was compared. Colonic masses detected in patients undergoing routine abdominal ultrasonography for abdominal symptoms were also reported. Forty-five of the 54 patients referred had colonic carcinoma and abdominal ultrasonography detected 43 of the tumours and correctly identified the site of 41. The sensitivity, specificity and accuracy of abdominal ultrasonography in the detection of colonic tumours considered to be consistent with a colonic carcinoma was 96, 67 and 91 per cent respectively. Seven tumours were identified in patients referred before any other investigation had been carried out. Abdominal ultrasonography may detect a colonic mass or wall thickening consistent with a colonic carcinoma with a high degree of accuracy and may be useful when barium enema or colonoscopy is not possible.

Accuracy of Ultrasonography in the Diagnosis of Peritonitis Compared With the Clinical Impression of the Surgeon—Invited Critique

Hypothesis: Peritonitis is a well-known indication for surgery, but its preoperative cause usually is not established. We hypothesize that abdominal ultrasonography is superior to the clinical impression of the surgeon in detecting the cause of peritonitis. Design: A prospective case series. Setting: A major university hospital in Taiwan, Republic of China. Patients and Methods: One hundred two patients with a diagnosis of peritonitis admitted to the Department of Emergency Medicine, National Taiwan University Hospital, Taipei, were included in this study. All 102 patients underwen an abdominal ultrasonographic examination; and the ultrasonographic findings of these patients ere classified into 2 categories: positive findings and normal screening results. The accuracy of clinical impression in detecting the cause of peritonitis was compared with the accuracy of abdominal ultrasonography. Results: Ultrasonography and clinical impression accurately diagnosed the peritonitis in 85 (83.3%) and 52 (51.0%) of the patients, respectively. The difference between ultrasonography and clinical impression in the diagnosis of peritonitis as significant (P<.001). Among 45 patients without a preoperative clinical diagnosis, a diagnosis was made by ultrasonography for 32 (71%) of them. There were a total of 98 patients with positive ultrasonographic findings, and 4 patients had normal screening results. Of the 98 patients with positive ultrasonographic findings undergoing surgery, all had abdominal pathological characteristics. The 4 patients with normal screening results received nonoperative treatment. Conclusions: Ultrasonography is a more sensitive technique than clinical judgment in diagnosing peritonitis. Ultrasonography may be a useful diagnosing modality in patients with peritonitis in whom the clinical cause is unclear.

Accuracy of abdominal ultrasonography and the role of a second investigation in surgical obstructive jaundice.

The diagnostic accuracy of ultrasonography (US) was evaluated in delineating the site and cause of biliary obstruction in 59 patients of surgical obstructive jaundice (SOJ). A final analysis of the ultrasonographic data was carried out in 42 patients on whom laparotomy or endoscopic papillotomy with removal of common bile duct stones, confirmed the diagnosis. Evaluation of the role of second investigation following ultrasound in 28 patients (side-viewing endoscopy in 13, ERCP in 12 and PTC in 3) was also done to determine whether they provide any additional information over ultrasonography in delineating the exact level and etiology of biliary obstruction. US was done by the clinician who interpreted the findings in conjunction with the clinical profile of the patient. US correctly diagnosed SOJ in all 42 patients. In 26 of the 28 patients with distal CBD block (specificity 87.5%; sensitivity 100%) and in 14 out of 16 patients with proximal CBD block (specificity 100%; sensitivity 87.5%) US provided and accurate diagnosis of the site of obstruction. US was correct in diagnosing a malignant etiology in 26 out of 27 malignant cases whereas it accurately indentified the benign nature of biliary obstruction in 14 of the 15 patients of SOJ due to benign obstruction (specificity and sensitivity range 93.3% to 96.3%). A second investigation could correctly change the etiology and site of biliary obstruction in only 5 patients (17.9%) whereas in the remaining 23 patients (82.1%) it did not add any additional information over the US findings. Six out of fifteen patients (40%) who underwent cholangiography had cholangitis and in one severe septicemia led to death.(ABSTRACT TRUNCATED AT 250 WORDS)