Difference In Diagnostic Efficacy Research Articles

A novel timesaving and semiquantitative method for radionuclide hepatobiliary scintigraphy for suspected biliary atresia.

To optimize the performance of the hepatobiliary scintigraphy (HS) for suspected biliary atresia (BA) using a timesaving and semiquantitative method without a loss in diagnostic accuracy. A retrospective analysis of 185 patients with persistent jaundice who underwent surgery were included. According to the surgical evaluation and pathological diagnosis, patients were divided into a BA group (99 cases) and an infant hepatitis syndrome (IHS) group (86 cases). 99mTc-labeled diethylacetanilide-iminodiacetic acid (99mTc-EHIDA) HS was performed before surgery. The average intestinal radioactivity uptake value minus the background average of radioactivity uptake value at 6 h after label injection (abbreviated as 6-h I-B) was calculated and the difference in 6-h I-B between the two groups was evaluated. The difference in diagnostic efficacy between 6-h I-B and the conventional 24-h HS in BA was also evaluated. A significant difference in 6-h I-B between the two groups was found (t=-5.975, P<0.001) and a high level of efficacy of 6-h I-B in the diagnosis of BA was detected. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of 6-h I-B in the diagnosis of BA were 87.88%, 47.67%, 69.19%, 65.91%, and 77.36% respectively, while the corresponding parameters of the 24-h hepatobiliary imaging were 90.91%, 36.05%, 65.41%, 62.07%, and 77.50% respectively, with no significant difference between these values in the diagnosis of BA. HS plays an important role in the diagnosis of infantile jaundice due to conjugated hyperbilirubinemia. The timesaving and semiquantitative method of the 6-h hepatobiliary static imaging showed the same high sensitivity and NPV of the conventional 24-h HS in preventing unnecessary surgery. In the setting of suspected BA, imaging resource utilization could be improved via reducing the acquisition time and simplifying the examination process. The 24-h delay in imaging was considered unnecessary because it was not significantly superior.

Combined application of pharamcokinetic DCE-MRI and IVIM-DWI could improve detection efficiency in early diagnosis of ductal carcinoma in situ.

PurposeDuctal carcinoma in situ (DCIS) is a precursor of invasive ductal breast carcinoma (IDC). This study aimed to use pharamcokinetic dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) and intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI) for the early diagnosis of DCIS.MethodsForty‐seven patients, including 25 with DCIS (age: 28–70 yr, mean age: 48.7 yr) and 22 with benign disease (age: 25–67 yr, mean age: 43.1 yr) confirmed by pathology, underwent pharamcokinetic DCE‐MRI and IVIM‐DWI in this study. The quantitative parameters Ktrans, Kep, Ve, Vp, and D, f, D* were obtained by processing of DCE‐MRI and IVIM‐DWI images with Omni‐Kinetics and MITK‐Diffusion softwares, respectively. Parameters were analyzed statistically using GraphPad Prism and MedCalc softwares.ResultsAll low‐grade DCIS lesions demonstrated mass enhancement with clear boundaries, while most middle‐grade and high‐grade DCIS lesions showed non‐mass‐like enhancement (NMLE). DCIS lesions were significantly different from benign lesions in terms of Ktrans, Kep, and D (t = 5.959, P < 0.0001; t = 5.679, P < 0.0001; and t = 5.629, P < 0.0001, respectively). The AUC of Ktrans, Kep, D and the combined indicator of Ktrans, Kep, and D were 0.936, 0.902, 0.860, and 0.976, respectively. There was a significant difference in diagnostic efficacy only between D and the combined indicator (Z = 2.408, P = 0.016).ConclusionDCE‐MRI and IVIM‐DWI could make for the early diagnosis of DCIS, and reduce the misdiagnosis of DCIS and over‐treatment of benign lesions.

Detection of Epstein-Barr virus (EBV)-encoded microRNAs in plasma of patients with nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) latently infected by Epstein-Barr virus (EBV) expresses 40 EBV BART microRNAs (miRNAs). Difference in diagnostic efficacy of these miRNAs on NPC detection was observed. Here, we performed a comprehensive evaluation on the efficacy of these miRNAs. Quantitative polymerase chain reaction was performed on plasma nucleic acid isolated from patients with NPC and noncancer donors. For primary NPC, BART2-5P, BART6-3P, BART7-3P, BART7-5P, BART9-5P, BART11-3P, BART17-5P, and BART19-5P were significantly elevated. For recurrent NPC, plasma levels of BART2-3P, BART2-5P, BART5-3P, BART5-5P, BART6-3P, BART8-3P, BART9-5P, BART17-5P, BART19-3P, and BART20-3P were significantly increased. Area under curve (AUC) analysis showed that BART19-5P had the best performance to identify NPC which was serologically EBV DNA undetectable. For recurrent NPC, BART8-3P and BART10-3P had highest AUC value for identifying cancer in EBV DNA undetectable plasma. Our data supported the use of circulating EBV miRNAs in NPC and recurrent NPC detection.

Differentiating between malignant and benign solid solitary pulmonary lesions: are intravoxel incoherent motion and diffusion kurtosis imaging superior to conventional diffusion-weighted imaging?

To quantitatively compare the diagnostic values of various diffusion parameters obtained from mono- and biexponential diffusion-weighted imaging (DWI) models and diffusion kurtosis imaging (DKI) in differentiating between benign and malignant solitary pulmonary lesions (SPLs). Multiple b-value DWIs and DKIs were performed in 89 patients with SPL by using a 3-T magnetic resonance (MR) imaging unit. The apparent diffusion coefficient (ADC) of various b-value sets, true diffusivity (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), apparent diffusional kurtosis (Kapp), and kurtosis-corrected diffusion coefficient (Dapp) were calculated and compared between the malignant and benign groups using a Mann-Whitney U test. Receiver-operating characteristic analysis was performed for all parameters. The ADC(0, 150) values of malignant tumors were lower than those of the benign group (p = 0.01). The ADC(0, 300), ADC(0, 500), ADC(0, 600), ADC(0, 800), ADC(0, 1000), ADCtotal, D, and Dapp of malignant tumors were significantly lower than those of benign lesions (all p < 0.001). D*, f, and Kapp showed no statistically significant differences between the two groups. ADCtotal showed the highest area under the curve (AUC = 0.862), followed by ADC(0, 800)(AUC = 0.844), ADC(0, 600)(AUC = 0.843), D(AUC = 0.834), ADC(0, 1000)(AUC = 0.834) and ADC(0, 500)(AUC = 0.824), Dapp(AUC = 0.796), and ADC(0, 300) (AUC = 0.773). However, the difference in diagnostic efficacy among these parameters was not statistically significant (p > 0.05). Intravoxel incoherent motion (IVIM) and DKI-derived parameters have similar performance compared with conventional ADC in differentiating SPLs. • Mono- and biexponential DWI and DKI are feasible for differentiating SPLs. • ADC (0, ≥500) has better performance than ADC (0, <500) in assessing SPLs. • IVIM and DKI have similar performance compared with conventional DWI in differentiating SPLs.

The application of 3-dimensional shear wave elastography in diagnosis of malignant and benign breast masses

Objective To investigate the application value of three-dimensional shear wave elastography(3D-SWE) in diagnosis of malignant and benign breast masses. Methods Sixty-seven patients with total 96 masses diagnosed by ultrasound and verified with surgical pathological analysis were selected. The masses were divided into benign group (54 masses) and malignant group (42 masses). The quantitative diagnosis was performed using two-dimensional shear wave elastography(2D-SWE) and 3D-SWE to evaluate the hardness of the masses. Receiver operating characteristic (ROC) curves of 2D-SWE and 3D-SWE were drawn to calculate the sensibility and specificity in diagnosis of breast masses. The qualitative diagnosis was performed according to the elastic color image classification to classify the elastic images of the lesions into type Ⅰ-Ⅳ. Results The quantitative diagnosis: ① There were significant differences in Emean, Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D-SWE between the two groups (P 0.05); ③ Emean, Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D- SWE both exhibited high diagnostic performance.However, there was no significant difference in Emean, Emax and SD between 2D-SWE and 3D-SWE (P>0.05). The qualitative diagnosis of elastic color mode: type Ⅰ and type Ⅱ account for most planes of 2D-SWE and three orthogonal planes of 3D-SWE in benign masses, while type Ⅲ and type Ⅳ account for most in malignant masses.Among the malignant group, type Ⅲ on the 3D-SWE coronal planes was significantly more than other three types (P<0.05). Conclusions For quantitative diagnosis, 2D-SWE and 3D-SWE are both beneficial to differentiate benign from malignant masses, but there is no difference in diagnostic efficacy; for qualitative diagnosis, 3D-SWE can provide more diagnostic information than 2D-SWE, especially on the coronal planes of 3D-SWE. Key words: Ultrasonography, mammary; Breast neoplasms; Shear wave elastography

Acoustic Radiation Force Impulse (ARFI) Elastography and Serological Markers in Assessment of Liver Fibrosis and Free Portal Pressure in Patients with Hepatitis B.

BackgroundThe aim of this study was to investigate the feasibility of using acoustic radiation force impulse (ARFI) elastography, AST-to-platelet ratio index (APRI), and FIB-4 in assessing liver fibrosis and free portal pressure in patients with hepatitis B.Material/MethodsWe enrolled 126 patients with hepatitis B who underwent liver surgery at the General Surgery Department of the First Affiliated Hospital of Shihezi University Medical School from February 2013 to August 2015. Preoperatively, shear wave velocity (SWV) of the liver was measured with the Siemens S2000 ultrasound system to reflect liver stiffness. Serological markers were collected and fibrosis indices APRI and FIB-4 were calculated. Intraoperatively, liver tissues were harvested and free portal pressure (FPP) was measured. Postoperatively, fibrosis of liver tissues was pathologically staged.ResultsThe results of SWV, APRI, FIB-4, and FPP were all correlated with the degree of liver fibrosis (Spearman correlation coefficients: r=0.777, P<0.001; r=0.526, P<0.001; r=0.471, P<0.001; p<0.000; r=0.675, p<0.000). Receiver operating characteristic curve (ROC) analysis showed that the areas under the curve (AUC) of ARFI, APRI, and FIB-4 in diagnosing liver fibrosis were 0.830, 0.768, and 0.717, respectively, for stage F≥1; 0.861, 0.773, and 0.754, respectively, for stage F≥2; 0.941, 0.793, and 0.779, respectively, for stage F≥3; and 0.945, 0.783, and 0.754, respectively, for stage F=4. SWV, APRI, and FIB-4 were all correlated with FPP (Pearson correlation coefficients: 0.387, P<0.001; 0.446, P<0.001; 0.419, P<0.001).ConclusionsARFI, APRI, and FIB-4 can assess liver fibrosis in patients with hepatitis B when assessing the portal venous pressure. The difference in diagnostic efficacy between the 3 was not significant.

Automated Quantification of Neuropad Improves Its Diagnostic Ability in Patients with Diabetic Neuropathy

Neuropad is currently a categorical visual screening test that identifies diabetic patients at risk of foot ulceration. The diagnostic performance of Neuropad was compared between the categorical and continuous (image-analysis (Sudometrics)) outputs to diagnose diabetic peripheral neuropathy (DPN). 110 subjects with type 1 and 2 diabetes underwent assessment with Neuropad, Neuropathy Disability Score (NDS), peroneal motor nerve conduction velocity (PMNCV), sural nerve action potential (SNAP), Deep Breathing-Heart Rate Variability (DB-HRV), intraepidermal nerve fibre density (IENFD), and corneal confocal microscopy (CCM). 46/110 patients had DPN according to the Toronto consensus. The continuous output displayed high sensitivity and specificity for DB-HRV (91%, 83%), CNFD (88%, 78%), and SNAP (88%, 83%), whereas the categorical output showed high sensitivity but low specificity. The optimal cut-off points were 90% for the detection of autonomic dysfunction (DB-HRV) and 80% for small fibre neuropathy (CNFD). The diagnostic efficacy of the continuous Neuropad output for abnormal DB-HRV (AUC: 91%, P = 0.0003) and CNFD (AUC: 82%, P = 0.01) was better than for PMNCV (AUC: 60%). The categorical output showed no significant difference in diagnostic efficacy for these same measures. An image analysis algorithm generating a continuous output (Sudometrics) improved the diagnostic ability of Neuropad, particularly in detecting autonomic and small fibre neuropathy.

Comparison of detection and miss rates of narrow band imaging, flexible spectral imaging chromoendoscopy and white light at screening colonoscopy: a randomised controlled back-to-back study

ObjectiveVirtual chromoendoscopy (CE) is expected to enhance adenoma yield and reduce variation in performance between colonoscopists. This study aimed to compare the efficacy of narrow band imaging (NBI), flexible spectral...

Cost-effectiveness of two breast biopsy procedures: surgical biopsy versus vacuum-assisted biopsy

The aim of this study was to compare the cost-effectiveness of two breast biopsy procedures: surgical biopsy and vacuum-assisted biopsy (VAB). Between November 2008 and September 2009, 200 patients with suspicious breast lesions underwent biopsy procedures at our radiology department: 100 underwent VAB and 100 underwent surgical biopsy. 66 lesions were sampled under sonographic guidance, 109 under mammographic guidance and 25 under magnetic resonance guidance. All procedures were successfully completed. No significant differences in diagnostic efficacy were found between the biopsy procedures. Surgical biopsy has a higher unit cost compared with VAB. Our analysis emphasises the benefits of VAB compared with surgical biopsy in terms of both cost-effectiveness, and less invasiveness from a psychological and aesthetic point of view.

A Cost-effectiveness Analysis of Diagnostic Algorithms of Deep Vein Thrombosis at the Emergency Department

Introduction Suspected cases of deep vein thrombosis are common at emergency departments and they often require extensive and costly diagnostic testing. The objective of this study was to evaluate whether a diagnostic algorithm based upon pre-test probability and D-dimer in diagnosing deep vein thrombosis may be cost-effective from a societal perspective in a Swedish setting. Material and Methods The cost-effectiveness of two alternative diagnostic algorithms were calculated using decision analysis. An algorithm which out ruled deep vein thrombosis among low probability patients with negative D-dimer was compared to a traditional algorithm including compression ultrasonography and/or contrast venography for all patients. For sensitivity analysis, a third reversed algorithm, where D-dimer was followed by pre-test probability, was analyzed. Estimates of probabilities were obtained from a prospective management study, including 357 outpatients with clinical suspicion of deep vein thrombosis. Direct costs were estimated using prices from Scania, Sweden. Indirect costs were estimated using time spent at the local emergency department and gross average wages in Sweden. Results The total cost of the pre-test probability and D-dimer algorithm was estimated to €406 per patient and the traditional algorithm was estimated to €581 per patient. Reversing the order of the score and test resulted in an estimate of €421 per patient. Conclusion At no significant difference in diagnostic efficacy the algorithm based upon pre-test probability and D-dimer was cost-effective, while the reversed algorithm and diagnostic imaging for all patients were not.

18F-FDG PET in stage IB/IIB cervical adenocarcinoma/adenosquamous carcinoma

The diagnostic and prognostic value of (18)F-FDG PET in cervical adenocarcinoma/adenosquamous carcinoma (AC/ASC) is unclear. The aim of this study was to assess the value of PET in the management of cervical AC/ASC. Patients with resectable FIGO stage IB/IIB cervical AC/ASC receiving a preoperative MRI scan and a PET or PET/CT scan before radical surgery were eligible. Diagnostic efficacy was compared by receiver operating characteristic (ROC) analysis. Correlations between clinicopathological parameters and outcome and maximum standardized uptake values (SUVmax) of FDG uptake were evaluated. The study group comprised 83 patients (mean age 48.3 + or - 9.7 years) Five-year overall survival was 85.5%, with a median follow-up time of 38.6 months (range 2.8-87.2 months). Pelvic lymph node (PLN) and paraaortic lymph node (PALN) metastases were seen in 32.5% and 8.4% of patients, respectively. The difference in diagnostic efficacy in identifying metastatic PALN between PET and MRI was significant (PET versus MRI, area under the curve 0.832 versus 0.607, p=0.039). SUVmax in primary tumour was correlated with LN metastasis and deep stromal invasion. Overall survival was significantly related to FIGO stage, PLN metastasis, deep cervical stromal invasion, tumour size measured by MRI, and SUVmax of the primary cervical tumour. PET provided significantly better diagnostic efficacy than MRI in detecting PALN metastasis. Poor prognostic factors in cervical AC/ASC were SUVmax of the primary cervical tumour >5.3, stage IIB, deep cervical stromal invasion, tumour size measured by MRI > or = 40 mm, and PLN metastasis.

Comparison of 5-megapixel cathode ray tube monitors and 5-megapixel liquid crystal monitors for soft-copy reading in full-field digital mammography

Purpose To retrospectively compare the image quality, lesion detection, and the diagnostic efficacy of 5-megapixel (MP) cathode ray tube monitors (CRTs) and 5-MP liquid crystal display monitors (LCDs) for soft-copy reading in full-field digital mammography (FFDM). Materials and methods Informed consent was waived by the Institutional Review Board for the data analysis. A total of 220 cases were compared with two 5-MP (2048 × 2560 pixels) CRTs and two 5-MP (2048 × 2560 pixels) LCDs. Nine aspects of image quality (brightness, contrast, sharpness, noise, skin, fat, retromamillary space, glandular tissue, and detection of calcifications) were evaluated. In addition, the detection of breast lesions (mass, calcifications) and diagnostic efficacy, based on the BI-RADS classification, were correlated with histologic results ( n = 70) and follow-up ( n = 150). Results Each aspect of the image quality was rated significantly better for 5-MP LCDs ( p < 0.05) compared to the 5-MP CRTs. With 5-MP CRTs, 31 masses and 119 calcifications were detected, compared to 30 and 121 with 5-MP LCDs. The differences in diagnostic efficacy between 5-MP CRTs and 5-MP LCDs were not significant ( p = 0.157) although 5-MP CRTs yielded two false-negative results. Both lesions were rated BI-RADS 3 with 5-MP CRTs. Both were invasive carcinomas at histology. The sensitivity, specificity, positive and negative predictive values, and accuracy were 0.966, 0.975, 0.933, 0.988, and 0.973 for 5-MP CRTs, compared to 1.0, 0.963, 0.903, 1.0, 0.973 for 5-MP LCDs. Conclusion The image quality of 5-MP LCDs is significantly better than that of 5-MP CRTs for soft-copy reading in FFDM, based on histologic and follow-up correlation. However, lesion detection and diagnostic efficacy are comparable to 5-MP CRTs. The interpretation of the false-negative results suggests that the characterization of breast lesions with FFDM is not defined solely by the monitors, but is strongly influenced by the radiologist.

Diagnostic efficacy of a low-dose 32-projection SPECT 99mTc-sestamibi myocardial perfusion imaging protocol in routine practice

99mTc-labeled tracers can provide better imaging quality than does TI for myocardial perfusion imaging (MPI). Nevertheless, a large study showed no significant difference in diagnostic efficacy, implying that image quality, though not optimal, may be still adequate for reliable interpretation. We thus proposed a suboptimal low-dose 32-projection single-photon emission computed tomography (SPECT) 99mTc-sestamibi (99mTc-methoxyisobutylisonitrile) MPI protocol and evaluated its diagnostic efficacy. A total of 1007 patients undergoing the proposed rest-stress MPI protocol were included in the study for analysis. Among them, 218 had coronary angiography, which was used as the 'gold standard' for evaluating sensitivity and specificity. The normalcy rate was obtained from 47 patients with a low cardiovascular risk. The injected dosage for 99mTc-methoxyisobutylisonitrile resting and dipyridamole stress imaging is 185 and 555 MBq, respectively, with an interval of about 2 h between the two injections. Most of the patients completed the whole MPI within 3 h. Using this protocol, the sensitivity and specificity of the 218 patients with subsequent coronary angiography for determining coronary artery disease were 95 and 63%, respectively. The normalcy rate was 87%. Both the rest and stress images were adequate for confident interpretation. The proposed low-dose 32-projection SPECT protocol has a diagnostic efficacy comparable with that reported in the literature, most of which used a higher dose and 64-projection SPECT, with additional benefits of lower radiation exposure, lower cost, and shorter study time.

Extracellular gadolinium-based contrast media: Differences in diagnostic efficacy

Extracellular gadolinium-based contrast media: Differences in diagnostic efficacy

Extracellular gadolinium-based contrast media: Differences in diagnostic efficacy

Since the introduction of the first gadolinium-based contrast agent (Gd–CA) in 1988 it has become clear that these agents significantly improve the diagnostic efficacy of MRI. Studies on single agents have shown that, in comparison to unenhanced sequences, all agents help to improve the detection and delineation of lesions which can alter diagnosis in up to 40% of patients. Doubling or tripling the standard dose of 0.1 mmol/kg body weight may be beneficial for selected indications (e.g. brain perfusion, equivocal single dose study in MRI for brain metastasis, small vessel MR angiography). A more limited number of studies have compared the various agents. These studies do not show clinically significant differences in diagnostic efficacy between the various extracellular Gd–CA. Agents with higher concentration or protein binding may be relatively better suitable for selected applications (e.g. perfusion MRI). The higher relaxivity agents may be used in somewhat lower doses than the extracellular agents.

Procalcitonin in the early diagnosis of nosocomial sepsis in preterm neonates

To examine the diagnostic usefulness of procalcitonin (PCT), C-reactive protein and immature to total neutrophil ratio (I : T) in nosocomial sepsis among neonates treated in an intensive care unit. A retrospective analysis and comparison of diagnostic utility performed in preterm neonates using receiver operating characteristic curves for the diagnosis of culture-proven sepsis. A total of 78 clinically suspected sepsis episodes in 73 newborns were analysed. The median values of PCT were: 0.56 ng/mL (interquartile range (IQR) 0.33-1.32) in group with aseptic blood culture (n = 15), 2.69 ng/mL (IQR 1.10-5.29) in Gram-positive (n = 47) and 9.36 ng/mL (IQR 3.11-39.35) in Gram-negative sepsis (n = 16). Only PCT values were significantly different (P < 0.01) among all groups. This was also true when correction for differences in blood withdrawal time was implemented. The positive and negative predictive values of PCT in the diagnosis of sepsis equalled 97.5% and 88.9%, respectively, for a cut-off value of 0.99 ng/mL. PCT was significantly better in diagnosis of sepsis than I : T (P = 0.03). No other significant differences in diagnostic efficacy were noted. The diagnostic efficacy was the highest for measurements made two or more hours since the onset of symptoms. The PCT serum concentration is a valuable tool for early detection of nosocomial sepsis in infants. Highest levels of PCT were observed in Gram-negative infections.

Evaluation of the currently used diagnostic procedures for the detection of Brucella melitensis in sheep

A study was conducted to determine whether the use of the enzyme-linked immunosorbent assay (ELISA) improves detection of brucellosis in individual sheep. Sera from 132 sheep that aborted due to B. melitensis were used to assess the efficacy of the ELISA to detect brucellosis in sheep. ELISA results were compared with those of the serum agglutination test (SAT), complement fixation test (CFT), Rose Bengal Plate test (RBPT) and the skin delayed-type hypersensitivity (SDTH). Sera from 11132 sheep free from brucellosis were tested with the ELISA to determine its specificity. The results show little difference in diagnostic efficacy between SAT, CFT, RBPT and the SDTH test, although the skin test indicated infection in some seronegative sheep. A combination of CFT and SAT, or CFT and RBPT, or CFT and SDTH tests indicated brucellosis in 75–88% of the infected animals, whereas the ELISA indicated infection in 97–100% of those animals. Seventeen (0.2%) from the 11132 negative sheep sera tested positive with the ELISA, indicating a 99.8% specificity. We concluded that screening sheep for brucellosis with ELISA improves Brucella diagnosis, and in areas of low prevalence it will help to maintain flocks of sheep free from brucellosis.

Multiplanar reconstruction in MR imaging of the knee

Purpose: to compare standard MR sagittal and coronal imaging of the knee with the MR technique of finer sagittal imaging and subsequent reconstruction in any planeMaterial and Methods: Forty-seven patients took part in the study. Two radiologists each made two independent interpretations in every case, based on images of: a) 4-mm sagittal and coronal slices; and b) 1.2-mm sagittal slices with subsequent reconstructionResults: We found no significant difference in diagnostic efficacy between the two MR techniques. the reconstruction in any desired plane involved a potential reduction of 10 min in examination time but an increase of approximately 20 min in postprocessing timeConclusion: the use of multiplanar reconstruction offered no additional diagnostic value and no saving of time