OBJECTIVE. The purpose of this article is to validate both semiquantitative and quantitative ultrasound assessment of medial meniscal extrusion using MRI assessment as the reference standard. SUBJECTS AND METHODS. Ninety-three consecutive patients with chronic knee pain referred for knee MRI were evaluated by ultrasound and MRI on the same day. Two musculoskeletal radiologists assessed meniscal extrusion on ultrasound and MRI separately and independently and graded it semiquantitatively as follows: 0 (< 2 mm), 1 (≥ 2 mm and < 4 mm), and 2 (≥ 4 mm). Agreement between the ultrasound and MRI evaluations was determined using weighted kappa statistics. Intraclass correlation coefficients were used to evaluate agreement using the absolute values of extrusion (quantitative assessment). We further evaluated the diagnostic performance of ultrasound for the detection of medial meniscal extrusion using MRI as the reference standard. RESULTS. For semiquantitative grading, agreement between ultrasound and MRI was moderate for reader 1 (κ = 0.57) and substantial for reader 2 (κ = 0.64). Substantial agreement was found for both readers (intraclass correlation coefficients, 0.73 and 0.70) when comparing quantitative assessment of meniscal extrusion between ultrasound and MRI. Ultrasound showed excellent sensitivity (95% and 96% for each reader) and good specificity (82% and 70% for each reader) in the detection of meniscal extrusion. CONCLUSION. Ultrasound assessment of meniscal extrusion is reliable and can be used for both quantitative and semiquantitative assessment, exhibiting excellent diagnostic performance for the detection of meniscal extrusion compared with MRI.
Semiquantitative assessment of knee OA can be reliably performed using 3D TSE MRI, showing substantial to almost perfect agreement and high accuracy when compared to routine 2D TSE MRI. 3D TSE MRI also takes less time, which is important for large OA studies.
ObjectiveTo compare the diagnostic performance of the three-dimensional turbo
spin-echo (3D TSE) magnetic resonance imaging (MRI) technique with the
performance of the standard two-dimensional turbo spin-echo (2D TSE)
protocol at 1.5 T, in the detection of meniscal and ligament tears.Materials and MethodsThirty-eight patients were imaged twice, first with a standard multiplanar 2D
TSE MR technique, and then with a 3D TSE technique, both in the same 1.5 T
MRI scanner. The patients underwent knee arthroscopy within the first three
days after the MRI. Using arthroscopy as the reference standard, we
determined the diagnostic performance and agreement.ResultsFor detecting anterior cruciate ligament tears, the 3D TSE and routine 2D TSE
techniques showed similar values for sensitivity (93% and 93%, respectively)
and specificity (80% and 85%, respectively). For detecting medial meniscal
tears, the two techniques also had similar sensitivity (85% and 83%,
respectively) and specificity (68% and 71%, respectively). In addition, for
detecting lateral meniscal tears, the two techniques had similar sensitivity
(58% and 54%, respectively) and specificity (82% and 92%, respectively).
There was a substantial to almost perfect intraobserver and interobserver
agreement when comparing the readings for both techniques.ConclusionThe 3D TSE technique has a diagnostic performance similar to that of the
routine 2D TSE protocol for detecting meniscal and anterior cruciate
ligament tears at 1.5 T, with the advantage of faster acquisition.
Objective:To test the accuracy and reproducibility of ultrasound and computed
tomography (CT) for the quantification of abdominal fat in correlation with
the anthropometric, clinical, and biochemical assessments.Materials and Methods:Using ultrasound and CT, we determined the thickness of subcutaneous and
intra-abdominal fat in 101 subjects-of whom 39 (38.6%) were men and 62
(61.4%) were women-with a mean age of 66.3 years (60-80 years). The
ultrasound data were correlated with the anthropometric, clinical, and
biochemical parameters, as well as with the areas measured by abdominal
CT.Results:Intra-abdominal thickness was the variable for which the correlation with the
areas of abdominal fat was strongest (i.e., the correlation coefficient was
highest). We also tested the reproducibility of ultrasound and CT for the
assessment of abdominal fat and found that CT measurements of abdominal fat
showed greater reproducibility, having higher intraobserver and
interobserver reliability than had the ultrasound measurements. There was a
significant correlation between ultrasound and CT, with a correlation
coefficient of 0.71.Conclusion:In the assessment of abdominal fat, the intraobserver and interobserver
reliability were greater for CT than for ultrasound, although both methods
showed high accuracy and good reproducibility.
SUMMARYObjective: The purpose of this study is to describe the epidemiological profile of trauma victims assisted in a public hospital in Fortaleza -Brazil. It also intends to establish a relationship between the waiting time for primary care and the satisfaction level of those patients. Another topic assessed here is the analysis of the most frequent musculoskeletal pathologies in this population. Methods: A cohort randomized study was conducted during 2002-2003 in a public trauma hospital in Fortaleza -Brazil, where 500 emergency patients were enrolled. Results: The epidemiological profile found in this study is as follows: males (60.4%), young adults (ages ranging 15 -30 years old) (55%), Fortaleza residents (74%), low familiar income (60%), and relatively healthy, being the fractures the most frequent lesions observed (48%). Conclusion: Patients assisted in trauma hospitals constitute a major social problem, and, most of the cases, they present with severe lesions, which demonstrates the need and importance of investments in emergency medical services.
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