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Buttle SG, McMillan HJ, Davila J, Bokhaut J, Kovesi T, Katz SL, Ersu R. Respiratory failure in a patient with VACTERL association and concomitant spinal muscular atrophy. Pediatr Pulmonol 2023; 58:3314-3319. [PMID: 37750602 DOI: 10.1002/ppul.26657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/04/2023] [Accepted: 08/19/2023] [Indexed: 09/27/2023]
Affiliation(s)
- Sarah Grace Buttle
- Division of Neurology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Hugh J McMillan
- Division of Neurology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Jorge Davila
- Department of Medical Imaging, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Julia Bokhaut
- Division of Respirology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Thomas Kovesi
- Division of Respirology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Sherri L Katz
- Division of Respirology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Refika Ersu
- Division of Respirology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
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Sodhi KS, Rana P, Bhatia A, Saxena AK, Mathew JL, Winant AJ, Lee EY. Diagnostic utility of MDCT in evaluation of persistent stridor in children: Large airway causes and benefit of additional findings. Pediatr Pulmonol 2021; 56:2169-2176. [PMID: 33755342 DOI: 10.1002/ppul.25382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/11/2021] [Accepted: 03/17/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To assess the diagnostic utility of MDCT in the evaluation of persistent stridor in children for the underlying large airway causes and benefit of additional findings. METHODS All consecutive pediatric patients who underwent MDCT for the evaluation of persistent stridor from December 2018 to February 2020 were included. Two pediatric radiologists independently reviewed MDCT studies for the presence of abnormalities at six large airway levels: (1) nasopharynx, (2) oropharynx, (3) glottis, (4) subglottis, (5) trachea, and (6) mainstem bronchi. In addition, studies were evaluated for the presence of non-airway abnormalities. Interobserver agreement between two reviewers was evaluated with kappa statistics. RESULTS There were a total of 40 pediatric patients (age range: 1 day-4 years. MDCT detected large airway abnormalities in 20 (50%) out of 40 patients, including 4 (20%) in nasopharynx, 4 (20%) in glottis, 4 (20%) in trachea, 3 (15%) in subglottis, 3 (15%) in mainstem bronchi, and 2 (10%) in oropharynx. Non-airway abnormalities were seen in 13 (32.5%) children, including 9 (69%) in the lungs, 3 (23%) in the soft tissue, and 1 (8%) in the bone. The remaining 7 (17.5%) studies were normal. There was excellent interobserver agreement seen for detecting large airway and non-airway abnormalities (k > 0.90). CONCLUSION MDCT has high diagnostic utility in diagnosing large airway causes of persistent stridor in children. It can also provide additional information regarding non-airway abnormalities. Therefore, MDCT has the potential to be utilized as a noninvasive problem-solving imaging modality in pediatric patients with persistent stridor.
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Affiliation(s)
- Kushaljit S Sodhi
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pratyaksha Rana
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anmol Bhatia
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay K Saxena
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Joseph L Mathew
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Abbey J Winant
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Advanced Technologies for Imaging and Visualization of the Tracheobronchial Tree. Thorac Surg Clin 2018; 28:127-137. [DOI: 10.1016/j.thorsurg.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Su SC, Masters IB, Buntain H, Frawley K, Sarikwal A, Watson D, Ware F, Wuth J, Chang AB. A comparison of virtual bronchoscopy versus flexible bronchoscopy in the diagnosis of tracheobronchomalacia in children. Pediatr Pulmonol 2017; 52:480-486. [PMID: 27641078 DOI: 10.1002/ppul.23606] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 08/11/2016] [Accepted: 09/06/2016] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Flexible bronchoscopy (FB) is the current gold standard for diagnosing tracheobronchomalacia. However, it is not always feasible and virtual bronchoscopy (VB), acquired from chest multi-detector CT (MDCT) scan is an alternative diagnostic tool. We determined the sensitivity, specificity, and positive and negative predictive values of VB compared to FB in diagnosing tracheobronchomalacia. METHODS Children aged <18-years scheduled for FB and MDCT were recruited. FB and MDCT were undertaken within 30-min to 7-days of each other. Tracheobronchomalacia (mild, moderate, severe, very severe) diagnosed on FB were independently scored by two pediatric pulmonologists; VB was independently scored by two pairs (each pair = pediatric pulmonologist and radiologist), in a blinded manner. RESULTS In 53 children (median age = 2.5 years, range 0.8-14.3) evaluated for airway abnormalities, tracheomalacia was detected in 37 (70%) children at FB. Of these, VB detected tracheomalacia in 20 children, with a sensitivity of 54.1% (95%CI 37.1-70.2), specificity = 87.5% (95%CI 60.4-97.8), and positive predictive value = 90.9% (95%CI 69.4-98.4). The agreement between pediatric pulmonologists for diagnosing tracheomalacia by FB was excellent, weighted κ = 0.8 (95%CI 0.64-0.97); but only fair between the pairs of pediatric pulmonologists/radiologists for VB, weighted κ = 0.47 (95%CI 0.23-0.71). There were 42 cases of bronchomalacia detected on FB. VB had a sensitivity = 45.2% (95%CI 30.2-61.2), specificity = 95.5% (95%CI 94.2-96.5), and positive predictive value = 23.2 (95%CI 14.9-34.0) compared to FB in detecting bronchomalacia. CONCLUSION VB cannot replace FB as the gold standard for detecting tracheobronchomalacia in children. However, VB could be considered as an alternative diagnostic modality in children with symptoms suggestive of tracheobronchomalacia where FB is unavailable. Pediatr Pulmonol. 2017;52:480-486. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Siew Choo Su
- Queensland Children's Respiratory Centre and Children's Centre Health Research, Brisbane, Queensland, Australia.,Respiratory Unit, Department of Pediatrics, Hospital Tengku Ampuan Rahimah, Jalan Langat, Klang 41200, Selangor, Malaysia
| | - Ian Brent Masters
- Queensland Children's Respiratory Centre and Children's Centre Health Research, Brisbane, Queensland, Australia
| | - Helen Buntain
- Queensland Children's Respiratory Centre and Children's Centre Health Research, Brisbane, Queensland, Australia
| | - Kieran Frawley
- Department of Medical Imaging and Nuclear Medicine, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Anubhav Sarikwal
- Department of Medical Imaging and Nuclear Medicine, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Debbie Watson
- Department of Medical Imaging and Nuclear Medicine, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Frances Ware
- Department of Anesthesia, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Jan Wuth
- Department of Anesthesia, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Anne Bernadette Chang
- Queensland Children's Respiratory Centre and Children's Centre Health Research, Brisbane, Queensland, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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Preoperative assessment and classification of benign laryngotracheal stenosis: a consensus paper of the European Laryngological Society. Eur Arch Otorhinolaryngol 2015; 272:2885-96. [DOI: 10.1007/s00405-015-3635-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 04/19/2015] [Indexed: 12/19/2022]
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Chen X, Qu Y, Peng ZY, Lu J, Ma X, Hu W. Clinical value of multi-slice spiral computed tomography angiography and three-dimensional reconstruction in the diagnosis of double aortic arch. Exp Ther Med 2014; 8:623-627. [PMID: 25009630 PMCID: PMC4079402 DOI: 10.3892/etm.2014.1763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 04/29/2014] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to evaluate the clincal value of multi-slice spiral computed tomography (MSCT) in the diagnosis of double aortic arch (DAA) and analyze the associated angiography and 3D reconstruction imaging to increase the accuracy of DAA diagnosis. Clinical and imaging data from 15 patients diagnosed with DAA by MSCT were summarized and compared with the corresponding surgical observations. The DAA diagnosis by MSCT for the 15 patients was confirmed by the surgical observations. A total of 13 cases were categorized as type I (double arches are open), including nine with a larger right arch, two with a larger left arch and two with balanced arches. Two cases were categorized as type II (one atretic arch), characterized by left atretic arch. Among the 15 patients, ultrasound diagnosis succeeded in nine cases and failed in the rest. A single malformation was identified in only two cases, whereas the rest had single or multiple combination(s) of intracardiac and extracardiac malformations, including seven with different levels of tracheobronchial stenosis. MSCT was demonstrated to precisely diagnose DAA complicated by malformation and tracheobronchial stenosis. MSCT is an essential therapeutic strategy and serves as a primary method in DAA diagnosis.
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Affiliation(s)
- Xin Chen
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
| | - Yanjuan Qu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Zhi-Yuan Peng
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
| | - Jingguo Lu
- Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
| | - Xiaojing Ma
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
| | - Wenjuan Hu
- Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, Hubei 430022, P.R. China
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Jiao H, Xu Z, Wu L, Cheng Z, Ji X, Zhong H, Meng C. Detection of airway anomalies in pediatric patients with cardiovascular anomalies with low dose prospective ECG-gated dual-source CT. PLoS One 2013; 8:e82826. [PMID: 24324836 PMCID: PMC3855812 DOI: 10.1371/journal.pone.0082826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 10/29/2013] [Indexed: 12/03/2022] Open
Abstract
Objectives To assess the feasibility of low-dose prospective ECG-gated dual-source CT (DSCT) in detecting airway anomalies in pediatric patients with cardiovascular anomalies compared with flexible tracheobronchoscopy (FTB). Methods 33 pediatrics with respiratory symptoms who had been revealed cardiovascular anomalies by transthoracic echocardiography underwent FTB and contrast material–enhanced prospective ECG-triggering CT were enrolled. The study was approved by our institution review board and written informed consent was obtained from all patients’ guardian. DSCT examinations were performed to detect cardiovascular abnormalities using weight-adjusted low–dose protocol. Two radiologists independently performed CT image analysis. The FTB reports were reviewed by an experienced pulmonologist. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of DSCT in the detection of airway anomalies were assessed. The tracheobronchial stenoses revealed on FTB were graded. Effective radiation dose was calculated. Results Thirty cases were diagnosed with tracheobronchial narrowing and/or abnormality in 33 patients by FTB, while 3 patients had normal FTB findings. Twenty-eight cases were diagnosed with airway anomalies by CT, of which 27 were correct positive. 3 patients with normal findings at CT had findings of tracheobronchial narrowing due to tracheobronchomalacia at inspiration at FTB. Sensitivity and specificity of CT were 90.0% (95% CI: 72.3%, 97.4%) and 66.7% (95% CI: 12.5 %, 98.2 %), respectively. PPV and NPV were 96.4% (95% CI: 79.8 %, 99.8%) and 40.0% (95% CI: 7.3%, 83.0%), respectively. Overall accuracy of DSCT in detecting airway anomalies in pediatrics with cardiovascular anomalies was 87.9% (95% CI: 74.5%, 97.6%). In grading of tracheobronchial stenosis, images from CT correlated closely (r = 0.89) with those of FTB. Mean effective dose was 0.60±0.20 mSv. Conclusion In pediatric patients, ECG-triggered CT to evaluate congenital cardiovascular anomalies can also be used to diagnose and characterize fixed airway involvement in relation to the vascular structures.
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Affiliation(s)
- Hui Jiao
- Shandong Medical Imaging Research Institute, Shandong University, Ji’nan, Shandong, People’s Republic of China
| | - Zhuodong Xu
- Shandong Medical Imaging Research Institute, Ji’nan, Shandong, People’s Republic of China
- * E-mail:
| | - Lebin Wu
- Shandong Medical Imaging Research Institute, Ji’nan, Shandong, People’s Republic of China
| | - Zhaoping Cheng
- Shandong Medical Imaging Research Institute, Ji’nan, Shandong, People’s Republic of China
| | - Xiaopeng Ji
- Shandong Medical Imaging Research Institute, Shandong University, Ji’nan, Shandong, People’s Republic of China
| | - Hai Zhong
- Department of Radiology, the Second Hospital of Shandong University, Ji’nan, Shandong, China
| | - Chen Meng
- Shandong University Qilu children hospital, Ji’nan, Shandong, China
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Elhamd EA, Seifeldein GS, AbdelAziz NH. Multidetector computed tomography evaluation in neonatal respiratory distress: Clinical implication. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2013. [DOI: 10.1016/j.ejrnm.2012.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lee EY, Greenberg SB, Boiselle PM. Multidetector computed tomography of pediatric large airway diseases: state-of-the-art. Radiol Clin North Am 2011; 49:869-93. [PMID: 21889013 DOI: 10.1016/j.rcl.2011.06.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Advances in multidetector computed tomography (MDCT) technology have given rise to improvements in the noninvasive and comprehensive assessment of the large airways in pediatric patients. Superb two-dimensional and three-dimensional reconstruction MDCT images have revolutionized the display of large airways and enhanced the ability to diagnose large airway diseases in children. The 320-MDCT scanner, which provides combined detailed anatomic and dynamic functional information assessment of the large airways, is promising for the assessment of dynamic large airway disease such as tracheobronchomalacia. This article discusses imaging techniques and clinical applications of MDCT for assessing large airway diseases in pediatric patients.
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Affiliation(s)
- Edward Y Lee
- Division of Thoracic Imaging, Department of Radiology, Children's Hospital Boston and Harvard Medical School, 330 Longwood Avenue, Boston, MA 02115, USA.
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Abstract
Recent advances in multidetector computed tomography (MDCT) technology have transformed the imaging evaluation of the trachea and bronchi. Multiplanar 2-dimensional and 3-dimensional volume reconstruction techniques, including external rendering and virtual bronchoscopy, can be generated in mere minutes, thereby complementing conventional axial CT imaging in the depiction of various central airway disease processes including airway stenoses, central airway neoplasms, and congenital airway disorders. Paired inspiratory and dynamic expiratory MDCT imaging, along with newer cine CT imaging methods, have enhanced the assessment of tracheobronchomalacia in both adults and the pediatric population. In addition, MDCT imaging plays an essential complementary role to conventional bronchoscopy, facilitating planning and guidance of bronchoscopic interventions, and providing a noninvasive method for postprocedural surveillance.
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Laroia AT, Thompson BH, Laroia ST, Beek EJRV. Modern imaging of the tracheo-bronchial tree. World J Radiol 2010; 2:237-48. [PMID: 21160663 PMCID: PMC2998855 DOI: 10.4329/wjr.v2.i7.237] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 06/09/2010] [Accepted: 06/16/2010] [Indexed: 02/06/2023] Open
Abstract
Recent state-of-the-art computed tomography and improved three-dimensional (3-D) postprocessing techniques have revolutionized the capability of visualizing airway pathology, offering physicians an advanced view of pathology and allowing for appropriate management planning. This article is a comprehensive review of trachea and main bronchi imaging, with emphasis on the dynamic airway anatomy, and a discussion of a wide variety of diseases including, but not limited to, congenital large airway abnormalities, tracheobronchial stenoses, benign and malignant neoplasms and tracheobronchomalacia. The importance of multiplanar reconstruction, 3-D reconstruction and incorporation of dynamic imaging for non-invasive evaluation of the large airways is stressed.
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Sodhi KS, Aiyappan SK, Saxena AK, Singh M, Rao K, Khandelwal N. Utility of multidetector CT and virtual bronchoscopy in tracheobronchial obstruction in children. Acta Paediatr 2010; 99:1011-5. [PMID: 20178519 DOI: 10.1111/j.1651-2227.2010.01729.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to evaluate the potential use of multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation of tracheobronchial patency in children with suspected bronchial obstruction and to compare its findings with fibreoptic/rigid bronchoscopy or surgery. PATIENTS AND METHODS A total of 43 children (15 girls, 28 boys) with clinically suspected bronchial obstruction underwent contrast enhanced MDCT, using an age- and weight- adjusted low dose protocol. Post-processing was performed and VB and multiplanar reformations (MPR) were obtained at the same sitting. Findings obtained at MDCT and VB were compared with fibreoptic/rigid bronchoscopy and surgery. RESULTS Obstructive pathology was found in 26 children, which included endoluminal foreign body, mucus plugs in 13 children, endobronchial tumour in three children and extrinsic compression (lymph node, aberrant Vessels, mediastinal cysts/tumours) of the tracheobronchial tree in 10 children. In 17 children, no obstructive lesion was identified. Excellent positive correlation was obtained, between MDCT-VB and bronchoscopy/surgery, however, in one child with endobronchial obstruction caused by tracheitis, low dose MDCT-VB was normal, but bronchoscopy revealed granularity and plaques. CONCLUSION MDCT-Virtual bronchoscopy is useful in evaluating bronchial stenosis and obstruction caused by both endoluminal pathology and external compression and has the advantage of looking beyond stenosis. Its main application lies in providing the exact location of suspected foreign body, prior to bronchoscopy. However, it fails to disclose exact nature of obstructing pathology.
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Affiliation(s)
- Kushaljit Singh Sodhi
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
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Qu X, Huang X, Wu L, Huang G, Ping X, Yan W. Comparison of virtual cystoscopy and ultrasonography for bladder cancer detection: a meta-analysis. Eur J Radiol 2010; 80:188-97. [PMID: 20452159 DOI: 10.1016/j.ejrad.2010.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/26/2010] [Accepted: 04/07/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND PURPOSE Bladder cancer is the most commonly diagnosed malignancy in patients presenting with haematuria. Early detection is crucial for improving patient prognosis. We therefore performed a meta-analysis to evaluate and compare the detection validity (sensitivity and specificity) of virtual cystoscopy (VC) and ultrasonography (US). METHODS We searched MEDLINE, EMBASE, PubMed and the Cochrane Library for studies evaluating diagnosis validity of VC and US between January 1966 and December 2009. Meta-analysis methods were used to pool sensitivity and specificity and to construct a summary receiver-operating characteristic (SROC) curve. RESULTS A total of 26 studies that included 3084 patients who fulfilled all of the inclusion criteria were considered for inclusion in the analysis. The pooled sensitivity for bladder cancer detection using CT virtual cystoscopy (CTVC), MR virtual cystoscopy (MRVC) and US was 0.939 (95% CI, 0.919-0.956), 0.908 (95% CI, 0.827-0.959) and 0.779 (95% CI, 0.744-0.812), respectively. The pooled specificity for bladder cancer detection using CTVC, MRVC and US was 0.981 (95% CI, 0.973-0.988), 0.948 (95% CI, 0.884-0.983) and 0.962 (95% CI, 0.953-0.969), respectively. The pooled diagnostic odd ratio (DOR) estimate for CTVC (604.22) were significantly higher than for MRVC (144.35, P<0.001) and US (72.472, P<0.001). CONCLUSION Our results showed that both CTVC and MRVC are better imaging methods for diagnosing bladder cancer than US. CTVC has higher diagnostic value (sensitivity, specificity and DOR) for the detection of bladder cancer than either MRCT or US.
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Affiliation(s)
- Xinhua Qu
- Department of Nuclear Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
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Veras TN, Hornburg G, Schner AMS, Pinto LA. Uso da broncoscopia virtual em pacientes pediátricos com suspeita de aspiração de corpo estranho. J Bras Pneumol 2009; 35:937-41. [DOI: 10.1590/s1806-37132009000900016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 05/03/2009] [Indexed: 11/22/2022] Open
Abstract
A aspiração de corpo estranho (ACE) para o trato respiratório é um problema comum em pacientes pediátricos, em especial abaixo dos três anos de idade. Na avaliação radiológica inicial, cerca de 30% dos pacientes apresentam radiograma de tórax normal. A tomografia com broncoscopia virtual (BV) pode auxiliar no diagnóstico precoce desse quadro e seu pronto manejo. O tratamento definitivo se dá com a retirada do corpo estranho através de broncoscopia rígida e mediante anestesia geral. O objetivo deste trabalho foi descrever o uso da BV na abordagem de dois pacientes com suspeita de ACE e realizar uma revisão da literatura sobre este tópico. Os dois pacientes tiveram início súbito de sintomas respiratórios e relato de tosse ou engasgo com alimentos antecedendo o quadro. Os pacientes foram submetidos à BV, e foi detectada a presença de corpo estranho endobrônquico em ambos os casos, com remoção posterior por broncoscopia rígida convencional em um caso. A BV é um método não-invasivo recente e com potencial para detectar a presença de corpo estranho na via respiratória em crianças. Em casos selecionados, BV pode auxiliar na localização correta do corpo estranho e até mesmo evitar o procedimento de broncoscopia rígida na ausência de corpo estranho.
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du Plessis J, Goussard P, Andronikou S, Gie R, George R. Comparing three-dimensional volume-rendered CT images with fibreoptic tracheobronchoscopy in the evaluation of airway compression caused by tuberculous lymphadenopathy in children. Pediatr Radiol 2009; 39:694-702. [PMID: 19399488 DOI: 10.1007/s00247-009-1262-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2008] [Revised: 02/09/2009] [Accepted: 03/14/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lymphobronchial tuberculosis (TB) causes airway compression in 38% of patients. The airway obstruction is conventionally assessed with fibreoptic tracheobronchoscopy (FTB). Multidetector-row spiral computed tomography (MDCT) with three-dimensional volume rendering (3-D VR) has significantly improved the imaging of the airways. No previous studies have assessed the accuracy of 3-D VR in determining the degree of airway compression in children due to TB lymphadenopathy. OBJECTIVE To compare 3-D VR CT to FTB for the assessment of airway compression due to TB lymphadenopathy in children. MATERIALS AND METHODS Included in the study were 26 children presenting with symptoms of airway compression caused by pulmonary TB. MDCT of the chest and FTB were performed in all patients. Retrospective 3-D VR reconstruction of the major airways was performed from the original CT raw data and used to evaluate the tracheobronchial tree for site and degree of airway compression and then compared to the FTB findings. FTB was used as the reference standard RESULTS By FTB 87 sites of airway compression were identified. Using the 3-D VR technique, 138 sites of airway compression were identified, of which 78 (90%) matched with the sites identified by FTB. The sensitivity and specificity of 3-D VR when compared with that of FTB was 92% and 85%, respectively. In four patients (15%), severe narrowing of the bronchus intermedius made FTB evaluation of the right middle and right lower lobe bronchi impossible. VR demonstrated significant distal obstruction in three of these four patients CONCLUSION 3-D VR demonstrates a very good correlation with FTB in determining airway compression caused by TB lymphadenopathy in children. In combination with FTB, 3-D VR adds confidence to the bronchoscopy findings and complements FTB by adding additional information on the status of the airway distal to severe obstructions unreachable by FTB.
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Affiliation(s)
- Jaco du Plessis
- Department of Radiology, University of Stellenbosch, P.O. Box 19063, Tygerberg, 7505, South Africa.
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Su YX, Feng ST, Liao GQ, Zhong YQ, Liu HC, Zheng GS. CT virtual sialendoscopy versus conventional sialendoscopy in the visualization of salivary ductal lumen: an in vitro study. Laryngoscope 2009; 119:1339-43. [PMID: 19507221 DOI: 10.1002/lary.20504] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the feasibility of computed tomographic (CT) virtual sialendoscopy and its performance characteristics for the visualization of salivary ductal lumen as compared with conventional sialendoscopy. STUDY DESIGN An in vitro study. METHODS Conventional sialendoscopy was performed in 16 submandibular glands in vitro and the surgical findings were recorded. Then a contrast agent was injected into the Wharton's duct via orifice. After CT scanning, the CT data were transferred to an independent workstation and were postprocessed with commercially available software to generate three-dimensional reconstructive and virtual sialendoscopic images. Finally, the plastination of submandibular glands was performed with 20% perchloroethylene ethyl acetate plastics filler to make cast specimens. CT three-dimensional reconstruction of the ductal system was compared with the cast specimen, and the performance of conventional sialendoscopy and CT virtual sialendoscopy for the visualization of salivary ductal lumen was also compared. RESULTS The CT data acquisition and postprocessing protocol were feasible. CT three-dimensional reconstruction enabled clear visualization of the ductal system from any directions and angles, which showed close resemblance to the cast specimens. And CT virtual sialendoscopy created clear endoluminal views of salivary ducts simulating those obtained with conventional sialendoscopy. CONCLUSIONS Our initial experience shows that CT virtual sialendoscopy has the potential to be an attractive imaging technique for the visualization of salivary ductal lumen.
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Affiliation(s)
- Yu-xiong Su
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Igarashi T, Suzuki H, Naya Y. Computer-based endoscopic image-processing technology for endourology and laparoscopic surgery. Int J Urol 2009; 16:533-43. [DOI: 10.1111/j.1442-2042.2009.02258.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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18
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Jin H, Min PQ, Yang ZG, Song B, Wu B. A study of multi-detector row CT scan on greater omentum in 50 individuals: correlating with anatomical basis and clinical application. Surg Radiol Anat 2008; 30:69-75. [PMID: 18058056 DOI: 10.1007/s00276-007-0283-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2007] [Accepted: 11/19/2007] [Indexed: 02/05/2023]
Abstract
BACKGROUND In view of the descriptions of the CT manifestations on the greater omentum (GO) were not precise and detailed enough in the previous literature, we tried to evaluate the radiologic-anatomical features of the GO and to address the related clinical implications for the radiologic diagnosis and surgical application. METHODS We evaluated the GO by using multi-detector row CT (MDCT) scanning in 50 individuals correlating with anatomical basis and clinical application. Emphasis was placed on the following items: the anatomical distribution and location of the GO; the CT manifestations of the vasculature, fatty tissue and lymph nodes. RESULTS The gastro-epiploic vessel, the landmark for delineating the GO, was visualized in 50/50 cases (100%). The gastro-colic vein was detected in 34/50 cases (68%). The free-hanging portion, 48 cases revealed, seemed to have the capability of 'migration': it is located in the subphrenic spaces in 9/48 cases (19%) and distributed in the right lower quadrant predominantly in 10/48 cases (21%). Three-dimensional reformatted images, obtained in five cases, demonstrated the return of the gastro-epiploic vein distinctly. Lymph nodes were rarely detected within the GO. CONCLUSION The depicted omental vessels, visualized by using multi-planar reconstruction images together with three-dimensional reformatted images, played a crucial role in delineating the GO comprehensively. It can provide the valuable data for the radiologic diagnosis and surgical therapy planning including surgery of reconstruction, pancreas, portal hypertension as well as infections and neoplastic diseases.
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Affiliation(s)
- Hang Jin
- Department of Radiology, West China Hospital, Sichuan University, Guo Xue Xiang, Chengdu, Sichuan 610041, China
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Advanced visualization of airways with 64-MDCT: 3D mapping and virtual bronchoscopy. AJR Am J Roentgenol 2007; 189:1387-96. [PMID: 18029875 DOI: 10.2214/ajr.07.2824] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this pictorial essay is to review the current role of virtual bronchoscopy and 3D imaging of the airways in clinical practice. CONCLUSIONS Virtual bronchoscopy produces high-resolution images of the tracheobronchial tree and endobronchial views that simulate the findings at conventional bronchoscopy. Interest in virtual bronchoscopy is increasing as a result of improvements in computer hardware and software and advances in MDCT that allow acquisition of isotropic data.
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Kagadis GC, Panagiotopoulou EC, Priftis KN, Vaos G, Nikiforidis GC, Anthracopoulos MB. Preoperative evaluation of the trachea in a child with pulmonary artery sling using 3-dimensional computed tomographic imaging and virtual bronchoscopy. J Pediatr Surg 2007; 42:E9-13. [PMID: 17502176 DOI: 10.1016/j.jpedsurg.2007.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pulmonary artery sling is frequently accompanied by tracheal anomalies other than local compression, including focal/segmental or extensive stenosis (ring-sling complex). Recent advances in computed tomography technology, such as multidetector computed tomography with 3-dimensional imaging (3-D) and virtual bronchoscopy (VB), offer important and accurate information of the entire tracheobronchial tree. We report on the value of 3-D imaging and VB in the preoperative assessment of a 4-year-old child with pulmonary artery sling and long segment tracheal stenosis owing to complete cartilaginous rings; we suggest that 3-D imaging and VB are important contributions in this assessment.
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Affiliation(s)
- George C Kagadis
- Department of Medical Physics, School of Medicine, University of Patras, GR 26500 Rio, Greece
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