ABSTRACT
AIM: The comparison between chest x-ray (CXR) and computed tomography (CT) images is commonly required in clinical practice to assess the evolution of chest pathological manifestations. Intrinsic differences between the two techniques, however, limit reader confidence in such a comparison. CT average intensity projection (AIP) reconstruction allows obtaining "synthetic" CXR (s-CXR) images, which are thought to have the potential to increase the accuracy of comparison between CXR and CT imaging. We aim at assessing the diagnostic performance of s-CXR imaging in detecting common pleuro-parenchymal abnormalities. MATERIALS AND METHODS: 142 patients who underwent chest CT examination and CXR within 24 hours were enrolled. CT was the standard of reference. Both conventional CXR (c-CXR) and s-CXR images were retrospectively reviewed for the presence of consolidation, nodule/mass, linear opacities, reticular opacities, and pleural effusion by 3 readers in two separate sessions. Sensitivity, specificity, accuracy and their 95% confidence interval were calculated for each reader and setting and tested by McNemar test. Inter-observer agreement was tested by Cohen's K test and its 95%CI. RESULTS: Overall, s-CXR sensitivity ranged 45-67% for consolidation, 12-28% for nodule/mass, 17-33% for linear opacities, 2-61% for reticular opacities, and 33-58% for pleural effusion; specificity 65-83%, 83-94%, 94-98%, 93-100% and 79-86%; accuracy 66-68%, 74-79%, 89-91%, 61-65% and 68-72%, respectively. K values ranged 0.38-0.50, 0.05-0.25, -0.05-0.11, -0.01-0.15, and 0.40-0.66 for consolidation, nodule/mass, linear opacities, reticular opacities, and pleural effusion, respectively. CONCLUSION: S-CXR images, reconstructed with AIP technique, can be compared with conventional images in clinical practice and for educational purposes.
Subject(s)
Radiography, Thoracic , Sensitivity and Specificity , Tomography, X-Ray Computed , Humans , Male , Female , Tomography, X-Ray Computed/methods , Middle Aged , Retrospective Studies , Aged , Radiography, Thoracic/methods , Adult , Aged, 80 and over , Radiographic Image Interpretation, Computer-Assisted/methods , Pleural Diseases/diagnostic imaging , Reproducibility of Results , Observer VariationABSTRACT
OBJETIVO: Relatar um caso de menina com doença de Ménétrier. DESCRIÇÃO DO CASO: Menina de dez anos, admitida com história de vômitos, diarréia, distensão e dor abdominal intermitentes há três dias. A suspeita foi apendicite e a paciente foi submetida à laparotomia, com achado de ascite e adenomegalia mesentérica. No pós-operatório, evoluiu com edema generalizado, ascite e derrame pleural. Os exames complementares e a evolução clínica demonstraram tratar-se de doença de Ménétrier. COMENTÁRIOS: O quadro clínico e os exames solicitados (alfa-1-antitripsina fecal aumentada, mucosa gástrica tipo fúndica com moderado grau de hiperplasia do epitélio luminal e foveolar e seriografia com hipertrofia do pregueado mucoso gástrico) confirmaram a doença de Ménétrier.
OBJECTIVE: To report a case of Ménétrier's disease in a girl. CASE DESCRIPTION: A 10-year-old girl was admitted to the hospital with a 3-day history of vomiting, diarrhea, intermittent distension and abdominal pain. Appendicitis was suspected, and patient had a laparotomy which showed only ascites and mesenteric adenomegaly. Generalized edema, ascites and right pleural effusion evolved after the surgery. Menetrier's disease was diagnosed by laboratorial exams and clinical evolution. COMMENTS: Clinical aspects and the increased fecal alpha-1-antitrypsin associated to gastric mucosa of fundic type with moderate level of hyperplasia of lumina and foveola epithelium and serioscopy with hypertrophy of the plica of gastric mucosa confirmed Ménétrier's disease.
