ABSTRACT
Abstract Objective To compare the imaging findings of anatomical alterations using multi-slice computed tomographic arthrography in the evaluation of rotator cuff tears in the shoulder, correlating them with the arthroscopy (the gold standard diagnostic test) findings. Materials and Methods A longitudinal, prospective, comparative study of diagnostic accuracy performed in the period between June 2016 and June 2017 in patients of both sexes, aged between 40 and 70 years, with shoulder rotator cuff tendon tears and therapeutic need to undergo shoulder arthroscopy. Patients with contraindication to magnetic resonance imaging were included. After multi-slice computed tomographic arthrography, all patients underwent arthroscopy. Results To obtain the results, the following parameters were determined: sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Kappa coefficient, and contrast between the imaging method and arthroscopy. Conclusion In the impossibility of performing magnetic resonance imaging (the gold standard imaging technique), multi-slice computed tomographic arthrography is an imaging examination capable of evaluating/diagnosing rotator cuff tears.
Resumo Objetivo Comparar os achados por imagem das alterações anatômicas da artrotomografia computadorizada multi-slice na avaliação das lesões do manguito rotador do ombro e correlacioná-los com os achados da artroscopia (exame diagnóstico padrão-ouro). Materiais e Métodos Estudo longitudinal, prospectivo, comparativo de acurácia diagnóstica, feito de junho de 2016 a junho de 2017, em pacientes de ambos os sexos, com idades entre 40 e 70 anos, com lesão dos tendões do manguito rotador do ombro, e que tinham necessidade terapêutica de fazer artroscopia do ombro. Foram incluídos pacientes com contraindicação à realização de ressonância magnética. Após a artrotomografia computadorizada multi-slice, todos os pacientes foram submetidos a artroscopia. Resultados Para a obtenção dos resultados, os seguintes parâmetros foram considerados: sensibilidade, especificidade, acurácia, valor preditivo positivo, valor preditivo negativo, coeficiente Kappa, e contraposição do método de imagem com a artroscopia. Conclusão Na impossibilidade da realização da ressonância magnética (exame de imagem padrão-ouro), a artrotomografia computadorizada multi-slice se mostra um exame de imagem capaz de avaliar/diagnosticar as lesões do manguito rotador.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Arthroscopy , Shoulder , Arthrography/methods , Magnetic Resonance Spectroscopy , Predictive Value of Tests , Rotator Cuff , Diagnostic Tests, Routine , Shoulder Injuries/classification , ContraindicationsABSTRACT
SUMMARY: The purpose of this research was to develop a free radiological anatomy software for radiologic anatomy education to assist students and professionals in health science. The study was divided into two phases: image acquisition and software development. The first phase was to obtain plain radiographic images and computed tomographic (CT) scans of an anthropomorphic phantom of head and neck. In addition, plain radiographic images of an anthropomorphic phantom of the chest were obtained. The second phase was the development of the anatomy software as an ImageJ macro. The software was developed through the insertion of the radiologic anatomy landmarks into the images that were obtained and application of multiple choice questions. The software was then tested for usability by getting the professors to answer the multiple choice questions. The software presented radiologic anatomy from 1) Head projections: Waters view, Towne view, Caldwell view, Lateral view, Submentovertex, PA view; 2) Thoracic Spine projections: AP and Lateral View and 3) Chest: PA view, Lateral and Oblique. Tomographic imaging presented one hundred radiologic landmarks of head. In total, there were 354 questions. A final report containing the score of correct answers, as well as the user ID, Date and Time of the test were showed. The test were available in three languages (Spanish, English and Portuguese). A user-friendly and inexpensive software was developed and presented. Students and professionals from several countries are able to practice, repeatedly, the recognition of radiologic anatomical landmarks.
RESUMEN: El propósito de esta investigación fue desarrollar un software gratuito de anatomía radiológica para la educación de anatomía radiológica para ayudar a estudiantes y profesionales de ciencias de la salud. El estudio se dividió en dos fases: adquisición de imágenes y desarrollo de software. La primera fase consistió en obtener imágenes radiográficas simples y tomografías computarizadas (TC) de un fantasma antropomórfico de cabeza y cuello. Además, se obtuvieron imágenes radiográficas simples de un fantasma antropomórfico del tórax. La segunda fase fue el desarrollo del software de anatomía como una macro ImageJ. El software se desarrolló a través de la inserción de los puntos de referencia de la anatomía radiológica en las imágenes que se obtuvieron y la aplicación de preguntas de opción múltiple. Luego, se probó la usabilidad del software haciendo que los profesores respondieran las preguntas de opción múltiple. El software presentó la anatomía radiológica de 1) Proyecciones de la cabeza: vista de aguas, vista de Towne, vista de Caldwell, vista lateral, Submentovertex, vista de PA; 2) proyecciones de la columna torácica: vista AP y lateral y 3) Cofre: vista de PA, lateral y oblicua. Las imágenes tomográficas presentaron cien puntos de referencia radiológica de la cabeza. En total, hubo 354 preguntas. Se mostró un informe final con la puntuación de las respuestas correctas, así como la identificación del usuario, la fecha y la hora de la prueba. Las pruebas estaban disponibles en tres idiomas (español, inglés y portugués). Se desarrolló y presentó un software fácil de usar y de bajo costo. Estudiantes y profesionales de varios países pueden practicar, repetidamente, el reconocimiento de puntos de referencia anatómicos radiológicos.