Diagnostic Accuracy Of High-resolution Ultrasonography Research Articles

Accuracy of High Resolution Ultrasonography for Diagnosis of Rotator Cuff Tears Con-sidering Magnetic Resonance Imaging as Gold Standard

Objective: To determine the diagnostic accuracy of high-resolution ultrasonography for the diagnosis of rotator cuff tears considering magnetic resonance imaging as gold standard. Methodology: This correlational study was done using non-probability consecutive sampling technique, at the Department of Orthopaedic Surgery and the Department of Radiology, Services Hospital Lahore from 15th July 2013 till 14th January 2016. All the patients, age between 40 to 70 years, who presented with shoulder pain for last three month, that was not settled with oral analgesic, and were positive for Hawkin’s -Kennedy test, Jobe’s test and drop arm were included in the study. Patients who had fracture of the clavicle, scapula or proximal end of humerus, and patients with prosthetic implants and pacemakers were excluded in the study. All clinical test positive patients underwent ultrasonography (USG) and magnetic resonance imaging (MRI). We calculated specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood ratio for ultrasonography. Results: Out of the total 92 patients, on MRI there were 68 (73.9%) complete and 24 (26.1%) partial Rotator Cuff Tears. USG diagnosed 62 out of 68 complete tears accurately. There were 21 true negative and 03 false positive complete tears. USG showed sensitivity of 91%, specificity of 87% (p-value

The Role Of High Resolution Ultrasonography To Differentiate Between Benign And Malignant Cervical Lymph Nodes In Oral Squamous Cell Carcinoma

Objectives:The purpose of the study was to evaluate the role of high resolution ultrasonography to differentiate between benign and malignant cervical lymph nodes in oral squamous cell carcinoma.Materials & Methods:The study was conducted in the Department of Oral and Maxillofacial Surgery, BSMMU,Dhaka, Bangladesh, during a period of January -2010 to December - 2011. A total number of 41 patients with clinical evidence of palpable cervical lymph nodes in oral squamous cell carcinoma were evaluated with high resolution ultrasonography. To evaluate the diagnostic accuracy of high resolutionultrasonography, the high resolution ultrasonography findings were compared and correlat- ed with histopathological examination after neck dissection.Results: All patients were pre-operatively examined by palpation and high resolution ultrasonography evaluation was done.Among them 41 study subjects, on high resolution ultrasonography evaluation 23(56.09%) lymph nodes were metastatic and 18(43.90%) lymph nodes were reactive. After postop- erative excisional histopathology examination 22(53.66%) lymph nodes were metastatic and 19(46.34%) lymph nodes were reactive in nature. Correlation of vascular flow pattern with histopatho- logical diagnosis showed that central flow for benign nodes, mixed & peripheral flow for malignant nodes were highly significant parameters (P<0.001). High resolution ultrasonography has specificity 78.94%, sensitivity 86.36% and diagnostic accuracy of the high resolution ultrasonography was 82.92%.Conclusion: High resolution ultrasonography can plays a definite role as an adjunct to the clinical evaluation of palpable cervical lymph nodes and proves its value as an important noninvasive investi- gation procedure for differentiating between benign and malignant cervical lymph nodes in oral squa- mous cell carcinoma.Update Dent. Coll. j: 2017; 7 (2): 19-27

Bayesian analysis of high-resolution ultrasonography and guided fine needle aspiration cytology in diagnosis of palpable thyroid nodules

IntroductionTo evaluate diagnostic accuracy of high-resolution ultrasonography in differentiation of benign and malignant thyroid nodules in comparison to results of guided fine needle aspiration cytology based on the Bayes rule. ObjectiveTo assess the validity of ultrasonography results of thyroid nodules in comparison to guided fine needle aspiration cytology findings. MethodsThis study was done on randomly chosen 80 patients presented with palpable thyroid nodules, undergone real-time sonographic evaluation of thyroid nodules to characterize features, internal consistency, margins, echotexture, calcification, peripheral lucent halo and vascularity. Ultrasonography guided fine needle aspiration cytology studies of thyroid nodules were done. ResultsPalpable thyroid nodules were highly prevalent in fourth and fifth decades of life with female–male ratio, 4:1. Solid internal consistency was demonstrated by 75% malignant nodules. Hypoechogenicity and intra-nodular micro-calcifications were observed in 92% malignant nodules; 83% malignant nodules had intra-nodular vascularity and absence of peripheral halo. The pre-test prevalence of malignant nodules in the targeted population was 17.5%. As type I error, 2.5% false-positive cases and as type II error, 5.0% false-negative cases were detected. Values of sensitivity and specificity of the ultrasonography test were 71.43 and 96.97%, respectively. ConclusionMalignant thyroid nodules demonstrated ultrasonography characteristics of hypoechoic texture, intra-nodular micro-calcifications, solid consistency, internal vascularity and absence of peripheral halo. The ultrasonography test has 92.5% diagnostic accuracy to differentiate malignant from benign lesions in comparison to the gold standard fine needle aspiration cytology test.

Comparison of high-resolution sonography and electrophysiology in the diagnosis of carpal tunnel syndrome.

Background:The diagnostic accuracy of high-resolution ultrasonography (HRUS) in comparison to electro-diagnostic testing (EDX) in carpal tunnel syndrome (CTS) is debatable.Objective:The aim of this study was to compare the diagnostic accuracy of HRUS with EDX in patients with various grades of CTS and CTS associated with peripheral neuropathy (CTS + PNP).Materials and Methods:A prospective cohort of 57 patients with possible CTS was studied along with matched controls. The cross-sectional area (CSA) of the median nerve at the inlet of carpal tunnel was assessed by a sonologist blinded to the clinical and EDX data. Palm wrist distal sensory latency difference (PWDSLD), second lumbrical-interosseus distal motor latency difference (2LIDMLD) and CSA were compared in patients with different grades of severity of CTS and CTS+PNP.Results:Total 92 hands of 57 patients met the clinical criteria for CTS. Mean CSA at the inlet of carpal tunnel was 0.11 ± 0.0275 cm2. It had the sensitivity, specificity, positive predictive value and negative predictive values of 76.43%, 72.72%, 89.47% and 68%, respectively (P < 0.0001). Overall, HRUS had good correlation with PWDSLD and 2LIDMLD electro-diagnostic studies in all grades of CTS and CTS + PNP.Conclusion:HRUS can be used as a complementary screening tool to EDX. However, EDX has been found to be more sensitive and specific in mild CTS.

Assessment of diagnostic accuracy of high-resolution ultrasonography in determination of temporomandibular joint internal derangement

The aim of this study was to determine the value of dynamic high-resolution ultrasonography (HR-US) in the evaluation of internal derangements of a temporomandibular joint (TMJ) in the open and closed mouth position. The study designed to collect the sample from the Outpatient Department of Oral Medicine and Radiology at GDC, Bangalore. Patients with pain, clicking, deviation, and tenderness were included in the study as a symptomatic group. The asymptomatic group was free of any symptoms. Maximum mandibular range of motion (Open and Closed) was performed during HR-US of TMJ in 100 consecutive patients, (50 symptomatic and 50 asymptomatic cases, a total of 400 joints, with 200 joints in the right and left closed and open mouth position;36 males and 64 females; age range, 16-50 years; mean age 27.56 years). Subsequently, the entire group, after clinical diagnosis, went for HR-US. Sonography confirmed the diagnosis by showing internal derangement in 34 (68%) of the symptomatic group and the remaining 16 (32%) patients failed to show any derangement. In the asymptomatic group 40 patients did not show any pathology associated with TMJ, whereas, 10 patients showed internal derangement. The data obtained was analyzed statistically. HR-US performed during the maximal range of motion (Open and Closed) helped to detect 34 instances (68 joints) of internal derangement, which were true positive cases, whereas, 16 patients (32 joints) showed a false positive finding for internal derangement (ID). The results obtained showed a sensitivity of 64%, specificity of 88%, positive predictive value of 84%, and a negative predictive value of 71%, with an accuracy of 76%. Dynamic HR-US being non-invasive can provide valuable information about internal derangement of the TMJ in mandibular closed mouth than open mouth position.

Ecografia ad alta risoluzione nella patologia cistica meniscale del ginocchio: nostra esperienza

This study was undertaken to assess the diagnostic accuracy of high-resolution ultrasonography (HRUS) in the detection of meniscal cysts. Over a 2-year period, 1,857 patients underwent magnetic resonance imaging (MRI) of the knee for traumatic or degenerative disorders. All patients with MRI evidence of a meniscal cyst were studied by HRUS. HRUS was also performed on an equal number of patients without MRI evidence of meniscal cyst who were used as a control group. All HRUS examinations were conducted by a radiologist blinded to the MRI findings. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of HRUS were assessed with reference to MRI. All patients underwent surgery, and the resected masses were studied by histological examination. MRI allowed identification of a meniscal cyst in 52 patients. HRUS enabled correct detection of the meniscal cyst in 49/52 cases. In the control group, HRUS excluded the presence of meniscal cysts in all cases. HRUS had a sensitivity, specificity, PPV and NPV of 94.23%, 100%, 100% and 94.54%, respectively, for the detection of meniscal cysts. HRUS is a fairly reliable technique in the detection, characterisation and differentiation of the different forms of meniscal cyst.

Age-Specific and Sex-Specific Differences in Diagnostic Accuracy of High-Resolution Ultrasonography for Acute Appendicitis

To evaluate the diagnostic capability of high-resolution ultrasonography (HRUS) for clinically suspected acute appendicitis in patients of different sex and age presenting with acute right lower quadrant pain at the Emergency Department of Tri-Service General Hospital, Taipei, Taiwan. The study included 734 consecutive patients (366 males and 368 females) in whom acute appendicitis was clinically suspected and evaluated using HRUS between January 1997 and November 1999. Patients were classified into two groups by sex, and further classified into four age groups (I = 0–17 yr; II = 18–45 yr; III = 46–60 yr; IV = > 60 yr) for categorical analysis. We retrospectively reviewed and compared the patients' HRUS images with their operative findings and histologic results to evaluate the overall age-specific and sex-specific diagnostic ability of HRUS for acute appendicitis. The chi-square test was used for categorical data analysis. Comparative analysis of our data with previously published data on the correlation between the prevalence of acute appendicitis and sonographic diagnosis of acute appendicitis was performed using linear regression. The overall accuracy, sensitivity, specificity, positive and negative predictive rates were 89%, 87%, 90%, 89% and 88%, respectively. Age-specific analysis revealed a statistically significant difference in diagnostic accuracy between age groups II and III among women (85% vs 96%, respectively; p < 0.05). Sexspecific analysis of age group II showed higher sensitivity (90% vs 77%; p < 0.05) and positive predictive values (89% vs 77%; p < 0.05) in women than in men, respectively. In age group III, the accuracy of HRUS was higher in men than in women (96% vs 84%, respectively; p < 0.05). The negative predictive value and overall diagnostic accuracy were negatively correlated to the prevalence of acute appendicitis. The value of HRUS for the diagnosis of acute appendicitis varied among different age and sex groups. The prevalence of acute appendicitis was negatively correlated with the negative predictive value and overall diagnostic accuracy of HRUS for acute appendicitis.