scholarly journals Diagnostic accuracy comparing OPT and CBCT in the detection of non‐vital bone changes before tooth extractions in patients with antiresorptive intake

Oral Diseases ◽  
2021 ◽  
Author(s):  
Oliver Ristow ◽  
Gregor Schnug ◽  
Maximilian Smielowksi ◽  
Julius Moratin ◽  
Maximilian Pilz ◽  
...  
Author(s):  
Ying-Hui Wang ◽  
Ruo-Han Ma ◽  
Jia-Jun Li ◽  
Chuang-Chuang Mu ◽  
Yan-Ping Zhao ◽  
...  

Objectives: To evaluate the diagnostic efficacy of CBCT–MRI fused image for anterior disc displacement and bone changes of temporomandibular joint (TMJ), which are the main imaging manifestations of temporomandibular disorders (TMD). Methods: Two hundred and thirty-one TMJs of 120 patients who were diagnosed with TMD were selected for the study. The anterior disc displacement, bone defect and bone hyperplasia evaluated by three experts were used as a reference standard. Three residents individually evaluated all the three sets of images, which were CBCT images, MRI images and CBCT-MRI fused images from individual CBCT and MRI images in a random order for the above-mentioned three imaging manifestations with a five-point scale. Each set of images was observed at least 1 week apart. A second evaluation was performed 4 weeks later. Intra- and interobserver agreements were assessed using the intraclass correlation coefficient (ICC). The areas under the ROC curves (AUCs) of the three image sets were compared with a Z test, and p < 0.05 was considered statistically significant. Results: One hundred and forty-five cases were determined as anterior disc displacement, 84 cases as bone defect and 40 cases as bone hyperplasia. The intra- and interobserver agreements in the CBCT-MRI fused image set (0.76–0.91) were good to excellent, and the diagnostic accuracy for bone changes was significantly higher than that of MRI image set (p<0.05). Conclusions CBCT-MRI fused images can display the disc and surrounding bone structures simultaneously and significantly improve the observers’ reliability and diagnostic accuracy, especially for inexperienced residents.


Author(s):  
Benedikt J. Schwaiger ◽  
Charlotte Schneider ◽  
Sophia Kronthaler ◽  
Florian T. Gassert ◽  
Christof Böhm ◽  
...  

Abstract Objectives To evaluate the performance of 3D T1w spoiled gradient-echo (T1SGRE) and ultra-short echo time (UTE) MRI sequences for the detection and assessment of vertebral fractures and degenerative bone changes compared with conventional CT. Methods Fractures (n = 44) and degenerative changes (n = 60 spinal segments) were evaluated in 30 patients (65 ± 14 years, 18 women) on CT and 3-T MRI, including CT-like images derived from T1SGRE and UTE. Two radiologists evaluated morphological features on both modalities: Genant and AO/Magerl classifications, anterior/posterior vertebral height, fracture age; disc height, neuroforaminal diameter, grades of spondylolisthesis, osteophytes, sclerosis, and facet joint degeneration. Diagnostic accuracy and agreement between MRI and CT and between radiologists were assessed using crosstabs, weighted κ, and intraclass correlation coefficients. Image quality was graded on a Likert scale. Results For fracture detection, sensitivity, specificity, and accuracy were 0.95, 0.98, and 0.97 for T1SGRE and 0.91, 0.96, and 0.95 for UTE. Agreement between T1SGRE and CT was substantial to excellent (e.g., Genant: κ, 0.92 [95% confidence interval, 0.83–1.00]; AO/Magerl: κ, 0.90 [0.76–1.00]; osteophytes: κ, 0.91 [0.82–1.00]; sclerosis: κ, 0.68 [0.48–0.88]; spondylolisthesis: ICCs, 0.99 [0.99–1.00]). Agreement between UTE and CT was lower, ranging from moderate (e.g., sclerosis: κ, 0.43 [0.26–0.60]) to excellent (spondylolisthesis: ICC, 0.99 [0.99–1.00]). Inter-reader agreement was substantial to excellent (0.52–1.00), respectively, for all parameters. Median image quality of T1SGRE was rated significantly higher than that of UTE (p < 0.001). Conclusions Morphologic assessment of bone pathologies of the spine using MRI was feasible and comparable to CT, with T1SGRE being more robust than UTE. Key Points • Vertebral fractures and degenerative bone changes can be assessed on CT-like MR images, with 3D T1w spoiled gradient-echo–based images showing a high diagnostic accuracy and agreement with CT. • This could enable MRI to precisely assess bone morphology, and 3D T1SGRE MRI sequences may substitute additional spinal CT examinations in the future. • Image quality and robustness of T1SGRE sequences are higher than those of UTE MRI for the assessment of bone structures.


JAMA ◽  
1966 ◽  
Vol 197 (2) ◽  
pp. 149-150 ◽  
Author(s):  
D. W. Gelfand

Author(s):  
Ling-Yu Guo ◽  
Phyllis Schneider ◽  
William Harrison

Purpose This study provided reference data and examined psychometric properties for clausal density (CD; i.e., number of clauses per utterance) in children between ages 4 and 9 years from the database of the Edmonton Narrative Norms Instrument (ENNI). Method Participants in the ENNI database included 300 children with typical language (TL) and 77 children with language impairment (LI) between the ages of 4;0 (years;months) and 9;11. Narrative samples were collected using a story generation task, in which children were asked to tell stories based on six picture sequences. CD was computed from the narrative samples. The split-half reliability, concurrent criterion validity, and diagnostic accuracy were evaluated for CD by age. Results CD scores increased significantly between ages 4 and 9 years in children with TL and those with LI. Children with TL produced higher CD scores than those with LI at each age level. In addition, the correlation coefficients for the split-half reliability and concurrent criterion validity of CD scores were all significant at each age level, with the magnitude ranging from small to large. The diagnostic accuracy of CD scores, as revealed by sensitivity, specificity, and likelihood ratios, was poor. Conclusions The finding on diagnostic accuracy did not support the use of CD for identifying children with LI between ages 4 and 9 years. However, given the attested reliability and validity for CD, reference data of CD from the ENNI database can be used for evaluating children's difficulties with complex syntax and monitoring their change over time. Supplemental Material https://doi.org/10.23641/asha.13172129


2007 ◽  
Vol 177 (4S) ◽  
pp. 649-649
Author(s):  
Ponnambalam Chandrasekar ◽  
Jeremy Raynard ◽  
Abdul Sayed ◽  
Faiyaz Kapasi ◽  
Jaspal S. Virdi ◽  
...  

2019 ◽  
Vol 25 ◽  
pp. 19
Author(s):  
Ravinder Jeet Kaur ◽  
Shobana Athimulam ◽  
Molly Van Norman ◽  
Melinda Thomas ◽  
Stefan K. Grebe ◽  
...  

VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Jie Li ◽  
Lei Feng ◽  
Jiangbo Li ◽  
Jian Tang

Abstract. Background: The aim of this meta-analysis was to evaluate the diagnostic accuracy of magnetic resonance angiography (MRA) for acute pulmonary embolism (PE). Methods: A systematic literature search was conducted that included studies from January 2000 to August 2015 using the electronic databases PubMed, Embase and Springer link. The summary receiver operating characteristic (SROC) curve, sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) as well as the 95 % confidence intervals (CIs) were calculated to evaluate the diagnostic accuracy of MRA for acute PE. Meta-disc software version 1.4 was used to analyze the data. Results: Five studies were included in this meta-analysis. The pooled sensitivity (86 %, 95 % CI: 81 % to 90 %) and specificity (99 %, 95 % CI: 98 % to 100 %) demonstrated that MRA diagnosis had limited sensitivity and high specificity in the detection of acute PE. The pooled estimate of PLR (41.64, 95 % CI: 17.97 to 96.48) and NLR (0.17, 95 % CI: 0.11 to 0.27) provided evidence for the low missed diagnosis and misdiagnosis rates of MRA for acute PE. The high diagnostic accuracy of MRA for acute PE was demonstrated by the overall DOR (456.51, 95 % CI: 178.38 - 1168.31) and SROC curves (AUC = 0.9902 ± 0.0061). Conclusions: MRA can be used for the diagnosis of acute PE. However, due to limited sensitivity, MRA cannot be used as a stand-alone test to exclude acute PE.


VASA ◽  
2019 ◽  
Vol 48 (6) ◽  
pp. 516-522 ◽  
Author(s):  
Verena Mayr ◽  
Mirko Hirschl ◽  
Peter Klein-Weigel ◽  
Luka Girardi ◽  
Michael Kundi

Summary. Background: For diagnosis of peripheral arterial occlusive disease (PAD), a Doppler-based ankle-brachial-index (dABI) is recommended as the first non-invasive measurement. Due to limitations of dABI, oscillometry might be used as an alternative. The aim of our study was to investigate whether a semi-automatic, four-point oscillometric device provides comparable diagnostic accuracy. Furthermore, time requirements and patient preferences were evaluated. Patients and methods: 286 patients were recruited for the study; 140 without and 146 with PAD. The Doppler-based (dABI) and oscillometric (oABI and pulse wave index – PWI) measurements were performed on the same day in a randomized cross-over design. Specificity and sensitivity against verified PAD diagnosis were computed and compared by McNemar tests. ROC analyses were performed and areas under the curve were compared by non-parametric methods. Results: oABI had significantly lower sensitivity (65.8%, 95% CI: 59.2%–71.9%) compared to dABI (87.3%, CI: 81.9–91.3%) but significantly higher specificity (79.7%, 74.7–83.9% vs. 67.0%, 61.3–72.2%). PWI had a comparable sensitivity to dABI. The combination of oABI and PWI had the highest sensitivity (88.8%, 85.7–91.4%). ROC analysis revealed that PWI had the largest area under the curve, but no significant differences between oABI and dABI were observed. Time requirement for oABI was significantly shorter by about 5 min and significantly more patients would prefer oABI for future testing. Conclusions: Semi-automatic oABI measurements using the AngER-device provide comparable diagnostic results to the conventional Doppler method while PWI performed best. The time saved by oscillometry could be important, especially in high volume centers and epidemiologic studies.


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