The value of conventional ultrasound combining with contrast-enhanced ultrasound in the diagnosis of xanthogranulomatous cholecystitis / 中华超声影像学杂志

Objective To explore the value of contrast-enhanced ultrasound (CEUS) in improving the diagnosis ability for xanthogranulomatous cholecystitis ( XGC ) and wall-thickening gallbladder cancer ( GBC) . Methods Forth-three patients with XGCs and 31 patients with wall-thickening GBCs proved by pathology were enrolled in this study ,the features on conventional ultrasound and CEUS were recorded ,and the preliminary diagnosis before and after CEUS were given by doctors . Results Significant differences were found in continuous gallbladder inner wall and arterial blood supplement on conventional ultrasound , 58 .1％ (25/43) had continuous inner wall and 34 .9％ (15/43) had arterial blood flow in XGCs compared to 19 .4％ (6/31) and 100％ in GBCs . On CEUS ,72 .1％ (31/43) demonstrated continuous gallbladder inner wall and 48 .8％ (21/43) had hypoechoic nodules in the wall in XGCs compared to 16 .1％ (5/31) and 19 .4％ (6/31) in GBCs ,respectively ( P <0 .05) . No significant difference was found in intra-calcification , infiltration to adjacent organs ,gallbladder stones and fast-in and fast-out enhanced pattern( P >0 .05) . The area under ROC curve was improved from 0 .701 to 0 .899 after combining with CEUS ( P < 0 .05 ) . Conclusions Conventional ultrasound combining with CEUS could help acquiring more effective ultrasonic information and may improve the differential diagnosis ability of XGCs and GBCs .

Diagnostic Ability of Swept-Source and Spectral-Domain Optical Coherence Tomography for Glaucoma

PURPOSE: To compare the diagnostic abilities of swept-source optical coherence tomography (OCT) [Deep Range Imaging OCT-1 (DRI-OCT)] and spectral-domain OCT (Cirrus HD-OCT) for glaucoma in Korean adults. MATERIALS AND METHODS: This retrospective study involved measuring peripapillary retinal nerve fiber layer (PP-RNFL) thickness, full macular thickness, and ganglion cell-inner plexiform layer (GC-IPL) thickness on two different OCT systems. We used three-dimensional optic disc scanning of DRI-OCT and included 12 clock-hour sectors for measurement of the PP-RNFL. Areas under receiver operating characteristic curves (AUCs) were calculated and compared to determine how well each system could distinguish control and glaucomatous patients. RESULTS: Ninety-one healthy and 58 glaucomatous eyes were included. Both systems could clearly distinguish between control eyes and eyes with moderate to severe glaucoma. Among all sectors, the AUC values of areas associated with glaucoma were >0.7 for both OCTs. The PP-RNFL sector of highest AUC value on both OCTs was the inferior sector of the clock-hour map (0.968 and 0.959 in DRI-OCT and Cirrus HD-OCT, respectively). Among macular thickness sectors, AUC values were highest on both OCTs for the outer inferior sector (0.859 and 0.853 in DRI-OCT and Cirrus HD-OCT, respectively). The GC-IPL also provided high diagnostic values (DRI-OCT and Cirrus HD-OCT were the best in the average and inferior sectors, respectively). CONCLUSION: Although the two OCT systems provided different thickness measurements, DRI-OCT exhibited as good, if not better, diagnostic ability for glaucoma as Cirrus HD-OCT in Korean adults.

Influencing factor of diagnosis capacity in toxicologic pathology diagnostic laboratories / 中国职业医学

OBJECTIVE: To observe the diagnostic capacity and its influencing factors in the toxicologic pathology diagnostic laboratories in China. METHODS: Inter-laboratory comparison of toxicologic pathology diagnosis was cosponsored by Chinese Society of Toxicology-Toxicologic Pathology Specialty Section and Guangdong Province Hospital for Occupational Disease Prevention and Treatment. Nine digital slices of digestive system lesions were screened as comparison samples,and the reference institution with toxicologic pathology diagnostic laboratories completed the diagnosis within the prescribed time. According to the three grades of “excellent”,“satisfaction”and “dissatisfaction”,the evaluation was carried out.RESULTS: A total of 74 reference institution participated in this comparison,which distributed in 20 provinces and 4 municipalities and 156 pathologists. The reference institutions were mainly distributed in North China,Southern China and East China. There was an average of 2 pathologists per laboratory,and in the quantity of academic title,the junior,intermediate,and senior was 15,70 and 46 persons respectively. Parasitic hepatocyte cysts( 97. 3%),adenocarcinoma of small intestine( 95. 9%) and polyarteritis nodosa of the pancreas( 89. 2%) had the highest rate of “excellent”grade,while the duodenal gland inflammation( 67. 6%),foam cell aggregation in colonic propria( 40. 5%) and hepatoma adenoma( 32. 4%) had the highest rate of dissatisfaction grade in the evaluation of single case. In the overall evaluation,reference laboratories reached the “excellent”grade and the “satisfaction”grade were 78. 4% and 21. 6% respectively.The number of pathologists provided by each reference laboratory had impacts on the overall evaluation level and the single case evaluation( neoplastic lesions) in the evaluation of single case( P < 0. 05). The types of the reference laboratory,the regional distribution and the grade of the academic title had no effect on the diagnostic ability( P > 0. 05). CONCLUSION: The reference laboratory is superior in diagnosing the digestive system lesions in the inter-laboratory comparison activity.The number of pathologists in the reference laboratory is one of the influencing factors of its diagnostic ability.

Diagnostic Ability of Spectral Domain OCT: Comparision between Preperimetric Glaucoma and Large Physiologic Cupping

PURPOSE: To assess the distinction ability for differentiating glaucoma patients based on optic disc, retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) measured using spectral domain optical coherence tomography (SD-OCT). Additionally, the diagnostic ability of these parameters was evaluated by comparing preperimetic glaucoma patients who frequently visited the clinic and normal patients with and without a large physiologic cup/disc (C/D) ratio. METHODS: Using SD-OCT, the optic disc, RNFL and GCIPL of preperimetic glaucoma patients were compared with normal people with and without a large C/D ratio from March, 2011 to December, 2014 at Department of Ophthalmology, Inha University Hospital. Preperimetic glaucoma was defined using the normal standard automated perimetry for glaucomatous optic nerve changes such as asymmetry of vertical C/D ratio, rim thinning, notching, excavation and RNFL defect. RESULTS: When comparing preperimetic glaucoma patients to normal people without large disc cupping, the most reliable parameter for optic disc parameters, vertical C/D ratio (0.89), showed more reliable diagnostic ability than the most reliable parameter for retinal nerve fiber, inferior RNFL thickness (0.79) and superonasal and inferonasal GCIPL thickness were the most reliable GCIPL parameters (p = 0.005 and 0.002, respectively). When comparing preperimetic glaucoma patients to normal people having a large physiologic disc cupping, average C/D ratio among optic nerve parameters, inferior RNFL thickness among RNFL thickness parameters and inferior GCIPL thickness among GCIPL parameters showed highly reliable diagnostic abilities. These 3 parameters were not statistically different (all p > 0.05) and had lower distinction ability than reported in previous studies. CONCLUSIONS: Diagnostic abilities of SD-OCT for distinguishing preperimetric glaucoma from normal people having large physiologic disc cupping were similar for optic disc, RNFL and GCIPL and showed low diagnostic ability than compared to normal people without large disc cupping.

Diagnostic ability of differential diagnosis in ameloblastoma and odontogenic keratocyst by imaging modalities and observers / 대한구강악안면방사선학회지

PURPOSE: To evaluate the diagnostic ability in differentiating between ameloblastoma and odontogenic keratocyst according to the imaging modalities and observers. MATERIALS AND METHODS: We evaluated thirty-six cases of ameloblastomas and forty-seven cases of odontogenic keratocysts all histologically confirmed. Six oral and maxillofacial radiologists diagnosed the lesions by 3 methods: using panoramic radiograph, using computed tomograph (CT), and using panoramic radiograph and CT. The observers were classified by 3 groups: group 1 had experienced over 10 years in oral and maxillofacial radiologic field, group 2 had experienced for 3-4 years, and group 3 was in the process of residentship. After over 2 weeks, the observers diagnosed them by the same methods. RESULTS: The ROC curve areas except for group 3 were the highest with interpretation using panoramic radiograph and CT, followed by interpretation using CT only, and the lowest with interpretation using panoramic radiograph only. The overall difference was not found in diagnostic ability among groups in using panoramic radiograph only, but there was difference in diagnostic ability of group 1 and 2 vs 3 in using CT only, and combination panoramic radiograph and CT. CONCLUSIONS: To differentiate between ameloblastoma and odontogenic keratocyst more accurately, the experienced oral and maxillofacial radiologist should diagnose with combination of panoramic radiograph and CT.

Comparative study of digital and conventional radiography for the diagnostic ability of artificial proximal surface caries / 대한치과보존학회지

Conventional intraoral radiography continues to be the most widely used image modality for the diagnosis of dental caries. But, conventional intraoral radiography has several shortcomings, including the difficulty of exposing and processing intraoral film of consistently acceptable quality. In addition, radiographic retaking that was the result of processing errors, may result in increased discomfort and radiation dose to the patient. Recently, various digital radiographies substitute for conventional intraoral radiography to overcome these disadvantages. The advantages of digital radiography are numerous. One of advantages is the elimination of processing errors. In addition, the radiation dose for digital system is approximately 20% to 25% of that required for conventional intraoral radiography. Another potential advantage of digital imaging is the ability to perform image quality enhancements such as contrast and density modulation, which may increase diagnostic accuracy. The purpose of this study was to compare the diagnostic ability of artificial proximal defects to conventional intraoral radiography, direct digital image(CDX2000HQ(R)) and indirect digital image(Digora(R)). Artificial defects were made in proximal surfaces of 60 extracted human molars using #1/2, #1, #2 round bur. Five dentists assessed proximal defects on conventional intraoral radiography, direct digital image(CDX2000HQ(R)) and indirect digital image(Digora(R)). ROC(Receiver Operating Characteristic) analysis and Two-way ANOVA test were used for the evaluation of detectability, and following results were acquired. 1. The mean ROC area of conventional intraoral radiography, direct digital image(CDX2000HQ(R))and indirect digital image(Digora(R)) were 0.6766, 0.7538, 0.6791(Grade I), 0.7176, 0.7594, 0.7361(Grade II), and 0.7449, 0.7608, 0.7414(Grade III), respectively. 2. Diagnostic ability of direct digital image was higher than other image modalities. But, there was no statistically significant difference among other imaging modalities for Grade I, II, III lesion(p>0.05). In conclusion, when direct and indirect digital system are comparable with conventional intraoral radiography, these systems may be considered an alternative of conventional intraoral radiography for the diagnosis of proximal surface caries.

Usefulness of Panoramic Radiography in the Detection of Maxillary Sinus Pathosis / 대한구강악안면방사선학회지

PURPOSE: to evaluate the usefulness of the panoramic radiography, generally used in dental clinic, for the detection of the maxillary sinus pathosis due to the inflammation and tumor, through the comparison with CT findings as the absolute standard. MATERIALS AND METHODS: 150 maxillary sinuses of 75 patients with or without particular signs and symptoms and showing soft tissue lesions or destruction of maxillary sinus walls in at least one sinus in CT, were selected as subject samples, and the panoramic radiography of the same patients were interpretated by 3 dental radiologists and 3 non dental radiologist given no previous informations. Using the CT findings as the absolute standard, the diagnostic ability of panoraimc radiography in the mucosal thickening, maxillary sinus haziness, inferior wall destruction, medial wall destruction, posterolateral wall destruction and the superior wall destruction was evaluated using the ROC curve and the difference between dental radiologist group and non dental radiologist group was also evaluated. RESULTS: 1. When dental radiologist group interpretated the destruction of inferior wall and posterolateral wall, the kappa value which shows interobserver's coincidence was above 0.75. 2. The diagnostic ability according to site of interpretation was the highest when the inferior wall was interpretated in both observer groups and there was a statistically significant difference between the dental radiologist group and non dental radiologist group in interpretating the mucosal thickening, haziness, destruction of the inferior and medial wall(p<0.05). 3. The diagnostic ability in detecting the destruction of the sinus walls was better than in soft tissue lesions in both groups and between the groups there was a statistically significant difference(p<0.05). CONCLUSION: When detecting the destruction of inferior and posterolateral wall of the maxillary sinus there was coincident with that of CT findings, and so it is considered that diagnostic ability of panoramic radiography is high in this point. But in interpretating the destruction of medial wall and soft tissue lesions, diagnostic ability of the panoramic radiography was relatively low and there was a significant difference between the dental radiologist group and non dental radiologist group. Therefore CT or other auxiliary diagnostic method will be necessary when evaluating thorough pathosis of maxillary sinus objectively.

A comparison of the diagnostic ability between waters' radiograph and computed tomography in the diagnosis of midf acial fracture / 대한구강악안면방사선학회지

This study was intended to compare the diagnostic ability between Waters' radiograph and CT in the diagnosis of mi dfacial fracture. The study group included 44 patients(male:32, female:12, age range:16-74 yeards old) with facial injur y who underwent surgery. Waters' radiograph and both axial and coronal scanning were performed before surgery, Three oral raiologists and thre e non-oral radiologist interpreted 44 waters' radiographs and 88 CT in three ways: 1) interpretation using waters' radi ograph only, 2) interpretation using CT only, 3) interpretation using Waters' radiograph and CT. The interpretation sites were confined to the walls of maxillary sinus; anterior, posterior, medial, lateral and superior wall. ROC curves were made with the findings during surery as a gold standard except the posterior wall, where the joint evaluation of Waters' radiograph and CT by othe three oral raiologists was used. ROC areas were compared according to the interpreting methods, the interpretation sites, and groups (R group ; oral r adiologist group, N group ; non-oral radiologist group). The obtained results were as followed : 1. The diagnostic ability of CT only and Waters' radiograph and CT was higher than Waters' radiograph only in b oth groups(P 2. Generally, the diagnostic ability for the lateral antral wall was the highest and that for the posterior antral wall was the lowest in both groups(P<0.05) 3. In R gruop, for the anterior antral wall the diagnostic ability using CT only was increased but for the medial, late ral and superior antral walls the diagnostic ability was increased in only using Waters' radiograph and CT. 4. In N group, for the anterior and medial walls the diagnostic ability using CT only was increased, But for the poster ior, lateral and superior antral walls there were no difference among three interpreting methods. 5. The diagnostic ability of R group was higher than N group in all interpreting methods.

A comparison of the diagnostic ability between waters' radiograph and computed tomography in the diagnosis of midf acial fracture / 대한구강악안면방사선학회지

This study was intended to compare the diagnostic ability between Waters' radiograph and CT in the diagnosis of mi dfacial fracture. The study group included 44 patients(male:32, female:12, age range:16-74 yeards old) with facial injur y who underwent surgery. Waters' radiograph and both axial and coronal scanning were performed before surgery, Three oral raiologists and thre e non-oral radiologist interpreted 44 waters' radiographs and 88 CT in three ways: 1) interpretation using waters' radi ograph only, 2) interpretation using CT only, 3) interpretation using Waters' radiograph and CT. The interpretation sites were confined to the walls of maxillary sinus; anterior, posterior, medial, lateral and superior wall. ROC curves were made with the findings during surery as a gold standard except the posterior wall, where the joint evaluation of Waters' radiograph and CT by othe three oral raiologists was used. ROC areas were compared according to the interpreting methods, the interpretation sites, and groups (R group ; oral r adiologist group, N group ; non-oral radiologist group). The obtained results were as followed : 1. The diagnostic ability of CT only and Waters' radiograph and CT was higher than Waters' radiograph only in b oth groups(P 2. Generally, the diagnostic ability for the lateral antral wall was the highest and that for the posterior antral wall was the lowest in both groups(P<0.05) 3. In R gruop, for the anterior antral wall the diagnostic ability using CT only was increased but for the medial, late ral and superior antral walls the diagnostic ability was increased in only using Waters' radiograph and CT. 4. In N group, for the anterior and medial walls the diagnostic ability using CT only was increased, But for the poster ior, lateral and superior antral walls there were no difference among three interpreting methods. 5. The diagnostic ability of R group was higher than N group in all interpreting methods.