ABSTRACT
Background and purpose: Pendred syndrome, defined traditionally as the constellation of goiter, sensori-neural hearing loss and positive perchlorate discharge test. Since the relatively newer approaches to the diagnosis of this syndrome, as MRI and genetic and/or molecular analysis are much more expensive and complicated than the traditional approaches, we planned to study the value and reliability of MRI as the sole, or adjunctive diagnostic approach to the syndrome
Materials and methods: We presumed the classic triad is still the most widely accepted gold standard, and compared MRI findings in six such defined patients with six seemingly incomplete forms with goiter and hearing loss, but with negative Perchlorate discharge test
Results: There were a sensitivity and specificity of 83.3% and 66.7%, respectively for MRI in patients fulfilling all three criteria and 66.7% and 100% for sensitivity and specificity in the group lacking perchlorate test positivity
Conclusion: Although MRI can not replace the holistic approach, In [partial] cases with equivocal findings, and in the evaluation of relatives of the patients MRI may be considered as a valuable diagnostic adjunct
ABSTRACT
Dual X-Ray energy Absorptiometry [DXA] is a method that can be used extensively for bone mineral densitometry [BMD]. A newer method is called DXL, associates dual X ray absorptiometry assisted by laserX-ray absorptiometry to the measures of heel thickness with a laser beam. In this study the cut off points for DXL of calcaneus in the diagnosis of osteoporosis in different bone regions in postmenopausal women were determined. In 268 postmenopausal women, BMD of the spinal and femoral regions was measured by DXA and the value for the heel calcaneous was measured by DXL. The agreement of the two methods in diagnosis of osteoporosis and optimal cut-off point for DXL in defining osteoporosis was obtained. DXA showed osteoporosis in 40.7% of cases with 35.2% in L2-L4, 16.2% in the femoral neck, and 11.7% for the femoral total region. The DXL found osteoporosis, considering -2.5 SD as a threshold, in 26.1% of cases. According to WHO criteria, agreementAgreement of the two methods in the diagnosis of osteoporosis [Kappa score] was 0.443 for the lumbar region, 0.464 for the neck, and, 0.421 for total femur regions [all P values were significant]. Using Receiver Operating Characteristic [ROC] curves, it was found that a T-score of -2.1, -2.6 and -2.4 as the optimal cut-off point of DXL in the diagnosis of osteoporosis in the lumbar spine, the neck and total region of femur, respectively. The results of this study showed a moderate agreement of the two methods in the diagnosis of osteoporosis. It seems that the DXL cannot be used as a substitute for the DXA method, but it can be used as a screening method for finding osteoporosis