Conversion and reliability of two urological grading systems in infants: the Society for Fetal Urology and the urinary tract dilatation classifications system.

BACKGROUND: The urinary tract dilation (UTD) classification system was proposed in 2014. OBJECTIVE: To evaluate the correspondence and reliability of two US grading systems for postnatal urinary tract dilatation in infants: the Society for Fetal Urology (SFU) and the UTD systems. MATERIALS AND METHODS: We assessed 180 kidneys in infants younger than 1 year. Four radiologists assessed the kidneys twice using both the SFU system (grades 0 to 4) and the UTD system (grades normal, P1, P2, P3). The SFU system was re-categorized into SFU-A (grades 0, 1-2, 3, 4) and into SFU-B (grades 0-1, 2, 3, 4). The Cohen kappa statistic was used for estimating agreement of both UTD-SFU-A and UTD-SFU-B. RESULTS: The Cohen kappa was significantly higher between UTD and SFU-B as compared to the UTD and SFU-A (0.75 vs. 0.50, P < 0.001). Intra-observer agreement was similar for the two grading systems (SFU 0.64-0.88 vs. UTD 0.48-0.92, P = 0.050-0.885). SFU grades 2 and 3 showed fair to moderate inter-observer agreement and corresponding UTD grades P1 and P2 showed moderate to substantial agreement. The overall inter-observer agreement was significantly higher for the UTD system than for the SFU system during the first assessment (95% confidence interval [CI]: right kidney, -0.069 to -0.062; left kidney, -0.048 to -0.043). CONCLUSION: Correspondence between the systems was poor using a recommended re-categorization (SFU-A). An alternative re-categorization (SFU-B) was found to be more appropriate for establishing correspondence between the systems. Both systems were reliable, with good intra- and inter-observer agreement for the assessment of infant kidneys, but the UTD system had better inter-observer agreement.

Comparison of Ultrasound-Guided Core Needle Biopsy and Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Solid Pancreatic Lesions.

OBJECTIVES: The objective of our study was to compare the diagnostic yield of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) using a 25-gauge needle and ultrasound (US)-guided core needle biopsy (CNB) using an 18-gauge core needle for diagnosis of solid pancreatic lesions. METHODS: This retrospective study was approved by our Institutional Review Board, and the requirement for informed consent was waived. Patients who underwent either EUS-guided FNA or US-guided CNB for a solid pancreatic lesion from January 2008 to December 2012 were included and reviewed. Fine-needle aspirations and CNBs were performed by experienced endoscopists and radiologists. The diagnostic yield, accuracy, technical failure rate, sensitivity, and specificity for malignancy were calculated and compared. RESULTS: A total of 106 biopsy attempts were undertaken in 89 patients (EUS-guided FNA, n = 70; US-guided CNB, n = 36). Biopsy specimens were successfully obtained in 98 biopsy attempts (EUS-guided FNA, n = 63; US-guided CNB, n = 35). The accuracy, technical failure rate, sensitivity, and specificity of EUS-guided FNA for malignancy (73.02%, 10.00%, 77.78%, and 44.44%, respectively) was not significantly different from those of US-guided CNB (88.57%, 2.78%, 87.10%, and 100%, respectively; P ≥ .089). Diagnostic performance did not differ between the modalities according to the size and the location of the lesion in the pancreas. However, the diagnostic yield of US-guided CNB (86.11%) was higher than that of EUS-guided FNA (65.71%, P = .035). CONCLUSIONS: The diagnostic yield of US-guided CNB for solid pancreatic lesions is superior to that of EUS-guided FNA.

Relationship between left ventricular mass and coronary artery disease in young adults: a single-center study using cardiac computed tomography.

We evaluated the relationship between coronary artery disease (CAD) and left ventricular mass (LVM) as measured by cardiac computed tomography (CT) in young adults ≤40 years of age. We retrospectively enrolled 490 consecutive individuals (383 males; mean age, 35.2 ± 4.4 years) who underwent cardiac CT. CAD was defined by the presence of any plaque detected by coronary CT angiography. Left ventricular (LV) function, including LVM, was automatically measured by a dedicated workstation. LVM and LVM index (LVMi) in patients with CT-detected CAD were compared to those of patients without CT-detected CAD. Logistic regression analysis was used to evaluate the relationship between cardiovascular risk factors and CAD. Fifty-five individuals had CT-detected CAD (11.2 %, 53 males). LVM measured by cardiac CT was 126.9 ± 30.0 g for males and 93.6 ± 20.9 g for females. LVM was higher (117.8 ± 30.8 vs. 133.6 ± 33.1 g, P < 0.001) in patients with CT-detected CAD compared with patients without CT-detected CAD. Obesity, hypertension, smoking, hypercholesterolemia, LVM and LVMi were predictors of CT-detected CAD. Body mass index (r = 0.237, P < 0.001) and systolic blood pressure (r = 0.281, P < 0.001) were positively correlated with LVM. In the multivariate analysis, LVM [odds ratio (OR) = 1.016] and LVMi (OR = 1.026) remained independent predictors of CAD. LVM and LVMi in patients with CT-detected CAD were higher than that of patients without CT-detected CAD. LVM and LVMi measured by cardiac CT were independent predictors of CAD.

Comparison of MR imaging features of solid pseudopapillary neoplasm of pancreas between male and female patients.

PURPOSE: To evaluate MR imaging features of solid pseudopapillary neoplasms (SPN) in male patients and to compare them with the MR imaging features in female patients. MATERIALS AND METHODS: Fifty patients who were histologically confirmed as SPN (M:F=8:42, mean age=36.4 years) with preoperative MRI were included. The following imaging features were reviewed: size, location, shape, margin, encapsulation, solid-cystic ratio, pancreatic duct dilatation, parenchymal atrophy, T1 signal intensity, T2 signal intensity, and morphological and dynamic pattern of enhancement. The statistical differences between male and female patients were analyzed. RESULTS: The average age of male patients (50.8 ± 4.1 years) was significantly higher (p<0.01) than female patients (33.7 ± 2.0 years). The shape of SPN in male patients was predominantly lobulated (n=6/8, 75.0%) compared to female patients, in whom oval shaped SPN was most prevalent (n=26/42, 61.91%) (P=0.02). SPN in male patients contained less cystic component (solid, n=4/8, 50.0%; mainly solid, n=4/8, 50.0%) while cystic (n=5/42, 11.90%) or mainly cystic (n=13/42, 30.95%) lesions were significantly more prevalent in female patients (P=0.03). The majority of SPNs in both groups showed progressive heterogeneous enhancement pattern. Other MR imaging features showed no significant differences between the male and female patients. CONCLUSION: On MRI, SPN in male patients appeared as mainly solid mass with a lobulating contour and heterogeneous progressive enhancement occurring at an older age than female patients. Recognition of imaging features of SPN in male patients compared to typical SPN in female patients should assist in correct differentiation of SPN from other pancreatic tumors.