Specificity Of High-resolution Computed Tomography Research Articles

The diagnostic utility of diffusion-weighted magnetic resonance imaging and high-resolution computed tomography for cholesteatoma: A meta-analysis.

The purpose of this meta-analysis was to compare the efficiency of high-resolution computed tomography (HRCT) and diffusion-weighted magnetic resonance imaging (DWI) in guiding the diagnosis of middle ear cholesteatoma in clinical practice. Cochrane Library, Medline, Embase, PubMed, and Web of Science were searched for studies that evaluated the sensitivity and specificity of HRCT or DWI in detecting middle ear cholesteatoma. A random-effects model was used to calculate and summarize the pooled estimates of sensitivity, specificity, and diagnostic odds ratios. Postoperative pathological results were considered as the diagnostic gold standard for middle ear cholesteatoma. Fourteen published articles (860 patients) met the inclusion criteria. The sensitivity and specificity of DWI when diagnosing cholesteatoma (regardless of type) were 0.88 (95% confidence interval [CI], 0.80-0.93) and 0.93 (95% CI, 0.86-0.97), respectively, while those of HRCT were 0.68 (95% CI, 0.57-0.77) and 0.78 (95% CI, 0.60-0.90), respectively. Notably, the sensitivity and specificity levels of DWI were similar to those of HRCT (p=.1178 for sensitivity, p=.2144 for specificity; pair-sampled t tests). The sensitivity and specificity of DWI or HRCT for the diagnosis of primary cholesteatoma were 0.78 (95% CI, 0.65-0.88) and 0.84 (95% CI, 0.69-0.93), respectively, while that for recurrent cholesteatoma were 0.93 (95% CI, 0.61-0.99) and 0.94 (95% CI, 0.82-0.98), respectively. DWI and HRCT have similar levels of high sensitivity and specificity in detecting various cholesteatomas. Also, the diagnostic efficiency of HRCT or DWI for recurrent cholesteatoma is identical to that of primary cholesteatoma. Therefore, HRCT may be used in clinical settings to reduce the use of DWI and save clinical resources. Data on the use of diffusion-weighted magnetic resonance imaging and high-resolution computed tomography in the diagnosis of cholesteatoma were obtained through a literature search. They were analyzed to guide the clinical diagnosis and treatment of cholesteatoma. NA.

Diagnosis of the Sputum Smear Positive and Sputum Smear Negative Pulmonary Tuberculosis - The Role of High - Resolution Computed Tomography of Chest

BACKGROUND
 Mycobacterium tuberculosis complex causes pulmonary tuberculosis (PT) which is a major public health problem worldwide and endemic in India. PT diagnosis is done by high-resolution computed tomography (HRCT) which has high sensitivity and specificity.
 METHODS
 At a tertiary hospital, this cross-sectional study was conducted for 3 years. Patients presenting with productive cough with or without haemoptysis, shortness of breath, fever with night sweats or weight loss were suspected of having tuberculosis and underwent HRCT. PT was defined as the presence of consolidation, centrilobular nodules, and branching nodules with a tree in bud appearance with or without lymphadenopathy and pleural effusion on HRCT.
 RESULTS
 In this study, a total of 118 patients with a mean age of 51.85 ± 16.86 years were included. 64 (54.2%) were males and 54 (45.76%) were females out of 118 patients. Sputum smear was negative in a total of 66 (55.9%) patients and positive in 52(44.06%) patients. 84.26% was the diagnostic accuracy of HRCT in diagnosing PT with sensitivity, specificity, PPV and NPV of 84.28%, 83.33%, 78.98%, and 99.02%, respectively. HRCT had diagnostic accuracy, sensitivity, specificity, PPV and NPV of 86.40%, 89.46%, 83.42%, 94.14% and 72.43%, respectively in sputum smear positive patients. Whereas it was 83.87%, 91.54%, 75.40%, 64.57%, and 92.14%, respectively in sputum smear negative patients.
 CONCLUSIONS
 In diagnosing sputum smear-positive and sputum smear-negative PT, HRCT has high sensitivity. The specificity of HRCT was high in diagnosing sputum smear-positive PT, whereas in case of sputum smear-negative PT it was slightly low.

Sensitivity and Specificity of High-Resolution Computed Tomography (HRCT) of Temporal Bone in Diagnosing Cholesteatoma and Its Correlation with Intraoperative Findings.

High resolution computed tomography (HRCT) of temporal bone helps in understanding the complex anatomy of temporal bone and in identifying disease in temporal bone. However, its role in diagnosing cholesteatoma and analyzing its extent and complications is not established unequivocally. Present study was undertaken to check sensitivity and specificity of HRCT in diagnosing cholesteatoma and assessing its extent and in identifying ossicular destruction and other complications. In this prospective study in 50 patients with clinical diagnosis of cholesteatoma, preoperative high-resolution temporal bone CT scans axial and coronal view were carried out and compared with intra-operative findings. Kappa statistics was used for radio-surgical correlation. Comparison of CT scan findings with intraoperative findings revealed perfect correlation for sigmoid plate erosion, mastoid cortex dehiscence and scutum erosion, strong correlation for erosion of malleus, posterior superior wall and peri labyrinthine cells, good for erosion of incus and stapes, labyrinthine fistula, tegmen erosion and extent of disease and moderate correlation for facial canal dehiscence. HRCT scan of the temporal bone is useful preoperative investigation for cholesteatoma surgery for identification and documentation of ossicular status, location and extent of disease, erosion of tegmen or sinus or labyrinthine dehiscence, with the exception of facial canal dehiscence. Although it serves as road map for surgery, it still has some false positives and false negatives and the importance of a skilful, aware and alert surgeon cannot be overemphasized.

Diagnostic Accuracy of High-Resolution Computed Tomography of Chest in Diagnosing Sputum Smear Positive and Sputum Smear Negative Pulmonary Tuberculosis.

IntroductionPulmonary tuberculosis (PTB) is caused by species of organisms in the Mycobacterium tuberculosis complex. It is a major public health problem worldwide and is endemic in Pakistan. Various clinical and biochemical markers exist for its diagnosis. Radiology has an important role in the diagnosis of PTB. Initially, a chest radiograph is warranted for PTB evaluation. High-resolution computed tomography (HRCT) also has high sensitivity and specificity for PTB diagnosis. Features of primary TB include consolidation, lymphadenopathy, pleural effusion and miliary nodules whereas post-primary TB include apical consolidation, nodules and cavitation. The aim of this study was to determine the diagnostic accuracy of HRCT chest in diagnosing sputum smear positive and smear negative PTB.MethodsA cross-sectional study was conducted at a large tertiary care teaching hospital. A retrospective review of medical records of patients who underwent HRCT chest and sputum acid-fast bacillus (AFB) direct smear and AFB culture for suspicion of PTB was undertaken. All HRCT chest examinations were performed on multislice computed tomography (CT) scanner. On HRCT, PTB was defined as the presence of consolidation, centrilobular nodules, branching nodules with tree in bud appearance with or without lymphadenopathy and pleural effusion. Diagnostic accuracy of HRCT including sensitivity, specificity, positive and negative predictive values was calculated using 2 x 2 table, taking findings of AFB culture as a gold standard.ResultsA total of 108 patients were included in this study with a mean age of 51.85 ± 16.86 years. Diagnostic accuracy of HRCT in diagnosing PTB was found to be 84.26% with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 89.09%, 79.25%, 81.67%, and 87.50%, respectively. In sputum smear positive patients, HRCT has diagnostic accuracy, sensitivity, specificity, PPV and NPV of 87.50%, 88.57%, 84.62%, 93.94%, and 73.33%, respectively. In sputum smear negative patients, HRCT has diagnostic accuracy, sensitivity, specificity, PPV and NPV of 81.67%, 90.00%, 77.50%, 66.67%, and 93.94%, respectively.ConclusionHRCT has high sensitivity in diagnosing sputum smear positive and sputum smear negative PTB. The specificity of HRCT in diagnosing sputum smear positive PTB was high, whereas it was slightly low in diagnosing sputum smear negative PTB. Overall diagnostic accuracy of HRCT was high in diagnosing PTB.

The Suprapyramidal Fossa

To clarify the position, occurrence rate, and configuration of the suprapyramidal fossa (SF) through surgical observation and 3-dimensional reconstruction. SF of 300 ears with chronic otitis media were observed during surgery. The air cell and its abutting structures, including the facial nerve (FN), were reconstructed using high-resolution computed tomography (HRCT) data. In 68.3% (n = 205) of patients, the SF was observed in surgery. It is situated at the posterior wall of the facial recess of the retrotympanum. This air cell, usually the only one present on the surface of the pyramidal segment of the FN canal (FNC), is usually the largest if small air cells are found nearby. Its delineated location is as follows: pyramidal eminence and the pyramidal segment of the FNC medially, the deeper external acoustic meatus laterally, the aditus ad antrum superiorly, the posterior part of the tympanic annulus, and the chordal ridge anterior-inferiorly. Its configuration varies between rounded (11.7%, n = 35), curved-rod (52.7%, n = 158), and irregular (4%, n = 12). Additionally, the sensitivity and specificity of HRCT in detecting the SF were 79.0% and 88.4%, respectively. Occurrence and configuration of the SF is not a rule; however, the positive positional relationship between the SF and the second genu of the FNC is a rule, if the SF is detected. Considering this, the SF may be an important anatomic landmark to identify the FN during otosurgery. However, HRCT has a limited diagnostic value when the SF is atypical.

High-resolution computed tomography and pulmonary capillary volume in patients with probable pulmonary Kaposi's sarcoma

Summary Objective : pulmonary Kaposi's sarcoma (KS) remains difficult to diagnose because of the poor specificity of clinical and radiological signs and the low yield of biopsies. Computed tomography (CT) has been used to describe characteristic aspects of pulmonary KS, and high-resolution CT (HRCT) may be able to depict more precise features. An increase in pulmonary capillary volume has been reported in patients with cutaneous KS. Design and patients : in a prospective study, we determined the specificity of HRCT for pulmonary KS and divided 51 HIV patients into four groups, as follows : 10 asymptomatic patients without KS (control group 1), 14 patients with cutaneous KS (control group 2), 15 patients with mucocutaneous KS (control group 3) and 12 patients with probable pulmonary KS (group 4) documented by HRCT and/or bronchoscopy. Major patterns of probable pulmonary KS i.e spiculated nodules and peribronchovascular thickenings were precisely described. Pulmonary function tests (PFT) were done in every case. Results : total lung capacity (TLC), transfer lung capacity ( DLco ) and its components: pulmonary capillary volume Vc and membrane factor Dm were not different in the 4 groups. Forced expiratory volume for one second over vital capacity (FEV1/VC) was significantly lower in control group 2 and in group 4 than in control groups 1 and 3. DLco was normal in patients with pulmonary KS (group 4); no significant change in Dm (mean = 71.5 ± 17.5 % of predicted values) or Vc (mean = 83.6 ± 14.1 % of predicted values) was observed. Conclusions : these results show that Vc alone is unsuitable for the early diagnosis of pulmonary KS, but that HRCT combined with bronchoscopy can yield findings strongly suggestive of pulmonary KS and obviate the need for more invasive investigations.