Objective To conduct a multireader validation study to evaluate the interobserver variability and the diagnostic accuracy for the lung involvement by COVID-19 of COVID-19 Reporting and Data System (CO-RADS) score. Methods This retrospective study included consecutive symptomatic patients who underwent chest CT and reverse transcriptase-polymerase chain reaction (RT-PCR) from March 2020 to May 2020 for suspected COVID-19. Twelve readers with different levels of expertise independently scored each CT using the CO-RADS scheme for detecting pulmonary involvement by COVID-19. Receiver operating characteristic (ROC) curves were computed to investigate diagnostic yield. Fleiss’ kappa statistics was used to evaluate interreader agreement. Results A total of 572 patients (mean age, 63 ± 20 [standard deviation]; 329 men; 142 patients with COVID-19 and 430 patients without COVID-19) were evaluated. There was a moderate agreement for CO-RADS rating among all readers (Fleiss’ K = 0.43 [95% CI 0.42–0.44]) with a substantial agreement for CO-RADS 1 category (Fleiss’ K = 0.61 [95% CI 0.60–0.62]) and moderate agreement for CO-RADS 5 category (Fleiss’ K = 0.60 [95% CI 0.58–0.61]). ROC analysis showed the CO-RADS score ≥ 4 as the optimal threshold, with a cumulative area under the curve of 0.72 (95% CI 66–78%), sensitivity 61% (95% CI 52–69%), and specificity 81% (95% CI 77–84%). Conclusion CO-RADS showed high diagnostic accuracy and moderate interrater agreement across readers with different levels of expertise. Specificity is higher than previously thought and that could lead to reconsider the role of CT in this clinical setting. Key Points • COVID-19 Reporting and Data System (CO-RADS) demonstrated a good diagnostic accuracy for lung involvement by COVID-19 with an average AUC of 0.72 (95% CI 67 – 75%). • When a threshold of ≥ 4 was used, sensitivity and specificity were 61% (95% CI 52 – 69%) and 81% (95% CI 76 – 84%), respectively. • There was an overall moderate agreement for CO-RADS rating across readers with different levels of expertise (Fleiss’ K = 0.43 [95% CI 0.42 – 0.44]). Electronic supplementary material The online version of this article (10.1007/s00330-020-07273-y) contains supplementary material, which is available to authorized users.
Our experience shows that the intersection syndrome is associated with typical signs on US. This imaging modality can be considered a reliable tool for diagnosing this syndrome and may eliminate the need for other more expensive tests.
Many studies have demonstrated an association between diffuse bilateral testicular microlithiasis (TM) and gonadal and extragonadal germ cell tumors. Nevertheless, it is still uncertain whether ultrasound surveillance is really necessary in patients with TM in the absence of other risk factors such as previous testicular cancer, a history of cryptorchidism or testicular atrophy. We report the cases of a 33- and a 39-year-old man presenting with a retroperitoneal extragonadal tumor. The first patient underwent an MRI examination in order to rule out a lumbosacral hernia: MRI images showed no slipped disks but a voluminous retroperitoneal solid mass. The histological analysis revealed an immature teratoma. The second patient came to the emergency department complaining of abdominal pain, vomiting, weight loss and mild jaundice: ultrasound examination showed a large, ill-defined heterogeneous abdominal mass, confirmed by CT and MRI examination. The histology diagnosed a yolk sac tumor. In both patients, the testicular sonography was performed to rule out a focal lesion, but it displayed bilateral TM without a focal testicular mass. Based on our direct experience, we highlight the importance of annual ultrasonographic surveillance of the testis and the retroperitoneal space in patients with occasionally detected TM.
Introduction: To demonstrate the usefulness of ultrasound (US) in quickly and effectively diagnosing the presence of a foreign body in the superficial soft tissues. Materials and methods: A young lumberjack underwent US examination due to pain and swelling of the back of his right hand. These symptoms are often due to the presence of a wooden splinter. Results: On the back of the right hand, US demonstrated a hyperechoic line with acoustic shadowing surrounded by a hypoechoic halo suggesting a foreign body. Next to it in the same area, several hypoechoic areas were observed. Conclusions: US can quickly identify the exact position of a foreign body embedded in the skin and soft tissues; US can furthermore provide information about the inflammatory process and its spreading.Sommario Introduzione: Dimostrare l'estrema utilità di un esame non invasivo, come l'ecografia, nel fare diagnosi veloce ed efficace di penetrazioni cutanee di corpi estranei. Materiali e metodi: Abbiamo sottoposto a esame ecografico della cute e del sottocute della mano destra un giovane taglialegna che lamentava, da alcuni giorni, dolore, tumefazione e secrezione purulenta in corrispondenza della presunta sede di penetrazione di una spina lignea (dorso mano destra). Risultati: L'esame ecografico, condotto a livello della presunta sede di penetrazione della spina, ha messo in luce la presenza di un'area lineariforme iperecogena, con cono d'ombra posteriore, circondata da un alone ipoecogeno; in tale sede si osservavano, inoltre, diverse aree irregolari ipoecogene, da riferire a un processo flogistico del sottocutaneo. Conclusioni: L'esame ecografico permette non solo di localizzare con estrema precisione e velocità la sede del corpo estraneo, ma fornisce anche informazioni sulla reazione infiammatoria del tessuto circostante. ª
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.