Objective. The present systematic review and meta-analysis were conducted to investigate the accuracy of ultrasound in the diagnosis of pneumothorax in neonates and adults. Method. The searches were conducted by two independent researchers (MS and HD) to find the relevant studies published from 01/01/2009 until the end of 01/01/2019. We searched for published literature in the English language in MEDLINE via PubMed, Embase™ via ovid, the Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID), KoreaMed, and LILACS, and we searched OpenGrey (http://www.opengrey.eu/) and the World Health Organization Clinical Trials Registry (http://who.int/ictrp) for unpublished literature and ongoing studies. The keywords used in the search strategy were pneumothorax or ultrasound or chest ultrasonography or neonate or adult or aerothorax or sensitivity or specificity or diagnostic accuracy. The list of previous study resources and systematic reviews was also searched for identifying the published studies (MS and HD). Analyses were performed using Meta-Disc 1.4. Results. In total, 1,565 patients (255 neonates, 1212 adults, and 101 pediatrics suspected of pneumothorax) were investigated in 10 studies. The overall specificity of chest ultrasound in the diagnosis of pneumothorax in both populations of adults and neonates was 85.1% at the confidence interval of 95 percent (95% CI 81.1%–88.5%). At the confidence interval of 95 percent, the sensitivity was 98.6% (95% CI 97.7%–99.2%). The diagnostic odds ratio was 387.72 (95% CI 76.204–1972.7). For the diagnosis of pneumothorax in neonates, the ultrasound sensitivity was 96.7% at the confidence interval of 95 percent (95% CI 88.3%–99.6%). At the confidence interval of 95 percent, the specificity was 100% (95% CI 97.7%–100%). For the diagnosis of pneumothorax in adults, the ultrasound sensitivity was 82.9% at the confidence interval of 95 percent (95% CI 78.3–86.9%). At the confidence interval of 95 percent, the specificity was 98.2% (95% CI 97.0%–99.0%). The diagnostic odds ratio was 423.13 (95% CI 45.222–3959.1). Analyzing studies indicated that the sensitivity of “absence lung sliding” sign for the diagnosis of pneumothorax was 87.2% (95% CI 77.7–93.7), and specificity was 99.4% (95% CI 96.5%–100%). DOR was 556.74 (95% CI 100.03–3098.7). The sensitivity of “lung point” sign for the diagnosis of pneumothorax was 82.1% (95% CI 71.7%–89.8%), and the specificity was 100% (at the confidence interval of 95% CI 97.6%–100%). DOR was 298.0 (95% CI 58.893–1507.8). Conclusion. The diagnosis of pneumothorax using ultrasound is accurate and reliable; additionally, it can result in timely diagnoses specifically in neonatal pneumothorax. Using this method facilitates the therapy process; lack of ionizing radiation and easy operation are benefits of this imaging technique.
Aims. The purpose of this study was to assess the diagnostic value of 18F-fluorodeoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) for detection of lymph node (LN) metastasis of colorectal cancer. Material and Methods. A computerized search was performed to determine the relevant articles, published before October 2019. Stata Statistical Software, version 15.0, and Meta-Disc (version 1.4) were used for the meta-analysis. Results. the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 0.65, 0.75, 4.57, and 0.37 respectively. Studies that used SUVmax cut-off value (≤2.5) demonstrated the best accuracy. Conclusion. 18F-FDG PET/CT shows a low sensitivity and high specificity for detecting the metastasis of LNs in patients with newly diagnosed colorectal cancer.
Introduction Rejecting, removing and repeating the process of taking diagnostic X-ray images could lead to professional and moral challenges in the case of radiologic imaging. The aim of this study was to investigate the reason for repetitive imaging and the types of images mostly repeated. Methods Radiographic images taken in this center in the first half of 1400 were evaluated. At the end of each week, repetitive images were referred to the researcher to analyze the frequency of repetitive radiographies and the causes. Results In this study, a total of 4916 radiographies taken in Ali Ibn-e-Abitibi Hospital during the first 6 months of the year 1400 were evaluated. Among 398 repetitive radiographies, 94 repetitions (23.62%) were due to inappropriate positioning, 92 repetitions (23.12%) were due to patient's movements, 56 repetitions (14.07%) were due to inadequate radiation, 51 repetitions (12.81%) were due to inadequate processing, 46 repetitions (11.56%) were due to inadequate preparation of the patient, and 59 repetitions(14.82 %) were due to other reasons Conclusion In this study, the rate of repetitive radiographies taken in Ali Ibn-e-Abi Talib Hospital was estimated as 8.10%, with the most common reason for repetitions being estimated inappropriate positioning. Considering the fact that repetitive radiography mostly depends on operator-related factors, it is recommended to repeat the study after educating staff in order to compare the rate and reason of repetition.
Urinary tract stones are the most common causes of urinary tract obstruction, leading to patient hospitalization in the emergency room. This study is aimed to evaluate the use of the mean resistance index (mRI) to predict hydronephrosis in patients admitted for acute renal colic. This prospective study was performed on 100 patients who were admitted to the emergency department (ED) with unilateral renal colic (RC) problem. At the first visit, the following was done for all patients: 1. blood was taken from them for laboratory studies; 2. ECG and cardiological test; 3. plain film of the urinary tract; 4. аbdominal US; 5. bilateral color doppler ultrasound (CDUS) with renal RI measurement. Based on the information collected at different times during the experiment, patients were divided into two groups: the group that showed signs of dilatation (group A) and the group with hydronephrosis (group B). The obtained data were analyzed statistically by SPSS version 20. A mRI with a 0.68 cut off value was the most accurate (AUC:0.878), and Sensitive (90%) cut-off value for prediction of hydronephrosis development among patients presenting with RC and renal stone. This cut-off value also provided the highest positive (94%) and negative (76%) predictive values. CDUS with RI measurement is an easy and non-invasive method that provides useful information about urinary tract obstruction stones in patients with unilateral RC. In our study, this method was able to predict successfully the onset of acute renal dilatation. This was done with different levels of sensitivity, specificity, accuracy and diagnostic efficiency that were higher than ultrasound. Daily use of CDUS in ED can improve ultrasound, especially when other methods are contraindicated. For example, the methods by which the patient is exposed to radiation (pregnancy, allergies, renal failure, etc.) or intravenous injection of contrast agents (urography and CT).
Objective: Various indices have been introduced for estimating sonographic gestational age and have demonstrated varied diagnostic accuracy. The aim of this study was to evaluate the correlation of fetal kidney length (FKL) with some other traditional measurement parameters in determining an accurate gestational age. Materials and Methods: In this prospective study, healthy pregnant women, who had completed a scheduled and routine obstetrical sonogram, were included. During the sonogram, the measurement indices, biparietal diameter (BPD), abdominal circumference (AC), crown rump length (CRL), head circumference (HC), femur length (FL), and FKL were analyzed. The obstetrical measurements had been taken every 4 weeks from the 20th week of the pregnancy, until the end of the pregnancy (e.g., 20th, 24th, 28th, 32nd, 36th, 40th weeks). After data collection, the measurement data were analyzed with SPSS software. Results: There were significant ( P < .05) high strength of associations between FKL and the routine measurements of BPD ( r = 0.668), AC ( r = 0.770), CRL ( r = 0.792), HC ( r = 0.791), and FL ( r = 0.803). Conclusion: These results suggest possible significant positive relationships between FKL and BPD, AC, CRL, HC, and FL. It can be assumed that FKL might be a suitable index for determining gestational age especially in the late second and third trimester, when other measurement indices are less accurate.
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