Comparison of Alternative Diagnostic Approaches for Managing Appendicitis in Children: The Effect of Disease Prevalence and Spectrum

Swarr, Daniel T.

doi:10.1542/peds.114.2.513

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…This has been shown in the application of SPAIR SSFSE for detection of active inflammation related to Crohn's disease of the small bowel (12). The use of MRI for evaluation of Crohn's disease (4,5) and appendicitis is compelling considering that most patients are young and have a greater concern for ionizing radiation-induced malignancies from CT (13)(14)(15)(16). Other intraabdominal inflammatory processes shown to be delineated by T2W FS imaging includes diverticulitis (1,17) pancreatitis (18,19), pyelonephritis (20), cholecystitis (21), and for evaluation of the acute abdomen (8,19,22).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of optimized inversion‐recovery fat‐suppression techniques for T2‐weighted abdominal MR imaging

Lauenstein

Sharma

Hughes

et al. 2008

Magnetic Resonance Imaging

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Purpose: To test the theoretical benefits of a spectral attenuated inversion-recovery (SPAIR) fat-suppression (FS) technique in clinical abdominal MRI by comparison to conventional inversion-recovery (IR) FS combined with T2-weighted (T2W) partial Fourier single shot fast spin echo (SSFSE).Materials and Methods: 1.5T MRI studies of the abdomen were performed in 28 patients with liver lesions (hemangiomas n ϭ 14; metastases n ϭ 14). T2W sequences were acquired using IR and SPAIR SSFSE. Measurements included retroperitoneal and mesenteric fat signal-to-noise (SNR) to evaluate FS; liver lesion contrast-to-noise (CNR) to evaluate bulk water signal recovery effects; and bowel wall delineation to evaluate susceptibility and physiological motion effects.Results: SPAIR-SSFSE images produce significantly improved FS and liver lesion CNR. The mean SNR of the retroperitoneal and mesenteric fat for SPAIR SSFSE was 20.5 Ϯ 10.2 (Ϯ1 SD) and 12.7 Ϯ 6.2, compared to 43.2 Ϯ 24.1 (P ϭ 0.000006) and 29.3 Ϯ 16.8 (P ϭ 0.0000005) for IR-SSFSE. SPAIR-SSFSE images produced higher CNR for both hemangiomas CNR ϭ 164 Ϯ 88 vs. 126 Ϯ 83 (P ϭ 0.00005) and metastases CNR ϭ 75 Ϯ 27 vs. 53 Ϯ 19 (P ϭ 0.007). Bowel wall visualization was significantly improved using SPAIR-SSFSE (P ϭ 0.002). Conclusion:The theoretical benefits of SPAIR over conventional IR FS translate into significant multiple improvements that can be measured on clinical abdominal MRI scans.

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Section: Discussionmentioning

confidence: 99%

Evaluation of optimized inversion‐recovery fat‐suppression techniques for T2‐weighted abdominal MR imaging

Lauenstein

Sharma

Hughes

et al. 2008

Magnetic Resonance Imaging

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“…Children who are more likely to have appendicitis may show clearer symptoms, resulting in a higher sensitivity. On the other hand, in one of the imaging studies, the children who were most likely to have appendicitis were sent directly to surgery and not included in estimates of the accuracy of the diagnostic protocol [11]. The authors reported a lower prevalence than Kosloske et al: 36% vs. 59%.…”

Section: Referral Filtermentioning

confidence: 98%

Diagnostic test accuracy may vary with prevalence: implications for evidence-based diagnosis

Leeflang¹,

Bossuyt²,

Irwig³

2009

Journal of Clinical Epidemiology

376

268

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“…It arises usually in patients aged between 45 and 70 years, without any significant difference between male and female [ 3 ]. Furthermore, PNP can affect also children and adolescents [ 11 , 12 , 13 , 14 ]. In this sub-group of patients, PNP is more frequently associated with Castleman’s disease and hematologic malignant disorders [ 11 , 13 ].…”

Section: Epidemiologymentioning

confidence: 99%

“…On the one hand, humoral-mediated cytotoxicity usually causes a prominent PV-like appearance [ 3 , 5 , 52 ]; on the other hand, cell-mediated cytotoxicity often determines lichenoid lesions [ 48 , 50 ]. Lichenoid lesions are frequently identified in children, predominantly on the torso and limbs [ 12 , 13 ]. Furthermore, a unique case of pemphigus vegetans-like PNP has been described [ 64 , 65 ].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…It has been reported that PNP and underlying malignancy do not have a parallel evolution [ 3 , 8 , 16 ]. Indeed, PNP lesions generally progress after removing the triggering malignancy or even when the malignancy is under control [ 11 , 13 , 16 ]. However, it has been shown that outcome is better in PNP patients with concurrent Castleman’s disease or benign thymomas after removing the tumor [ 92 ].…”

Section: Prognosismentioning

confidence: 99%

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Paraneoplastic Pemphigus: Insight into the Autoimmune Pathogenesis, Clinical Features and Therapy

Paolino

Didona

Magliulo

et al. 2017

IJMS

103

195

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Paraneoplastic pemphigus is a rare autoimmune skin disease that is always associated with a neoplasm. Usually, oral, skin, and mucosal lesions are the earliest manifestations shown by paraneoplastic pemphigus patients. The pathogenesis of paraneoplastic pemphigus is not yet completely understood, although some immunological aspects have been recently clarified. Because of its rarity, several diagnostic criteria have been proposed. Besides, several diagnostic procedures have been used for the diagnosis, including indirect immunofluorescence, direct immunofluorescence, and ELISA. We reviewed the most recent literature, searching on PubMed “paraneoplastic pemphigus”. We included also papers in French, German, and Spanish. We found 613 papers for “paraneoplastic pemphigus”. Among them, 169 were review papers. Because of its varying clinical features, paraneoplastic pemphigus still represents a challenge for clinicians. Furthermore, diagnosis and management of paraneoplastic pemphigus requires close collaboration between physicians, including dermatologist, oncologist, and otorhinolaryngologist.

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Comparison of Alternative Diagnostic Approaches for Managing Appendicitis in Children: The Effect of Disease Prevalence and Spectrum

Cited by 4 publications

References 6 publications

Evaluation of optimized inversion‐recovery fat‐suppression techniques for T2‐weighted abdominal MR imaging

Evaluation of optimized inversion‐recovery fat‐suppression techniques for T2‐weighted abdominal MR imaging

Diagnostic test accuracy may vary with prevalence: implications for evidence-based diagnosis

Paraneoplastic Pemphigus: Insight into the Autoimmune Pathogenesis, Clinical Features and Therapy

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