33 research outputs found
Radiologi toraks tuberkulosis paru
No full textBuku ini menyajikan teknik pembuatan dan cara pembuatan foto toraks yang benar, serta ilustrasi kasus yan gbanyak ditemukan dalam praktek sehari-har
AKURASI SISTIM SKORING CT SCAN TORAKS TANPA KONTRAS POTONGAN TERBATAS UNTUK MENEGAKKAN DIAGNOSIS TUBERKOLOSIS PARU DEWASA
No full textBackground: Tuberculosis (TB) is still a malo- CCl'JSeof morbidity and mortality in Indonesia. Thus we need a fast and accurate method in diagnosing pulmonary TB especially in adult smear negative TB cases. The limited slice non-enhanced thoracic CT and a standardized method of expertise, such as a scoring system, could be a fast, effective and relatively easy alternative to provide a greater accuracy in diagnosing adult pulmonary TB.
Objective: This study was performed to determine the accuracy of a scoring system using the limited slice non-enhanced thoracic CT in diagnosing adult pulmonary TB.
Methods: This cross sectional study was conducted in Department of Radiology, Persahabatan hospital, Jakarta, Indonesia and starting from September 2012 to June 2013. The subjects comprised of 130 patients suspected of having smear negative pulmonary TB. A limited slice nonenhanced
thoracic CT was performed to assess the diagnostic value
based on a scoring system. Pulmonary TB was diagnosed in 84
subjects compare to reference standard. The scoring system was calculated using bivariate and multivariate cox regression analysis. The variables included in the analysis were the patient's age, history of previous contact with pulmonary TB patients, history of smoking and 9 characteristic chest CT patterns of TB. The ROC analysis was done to found the cutoff point score prediction pulmonary TB value. Results: Based on limited slice non enhanced thoracic CT and done by scoring system, a total score of equal or more than 29 could diagnose pulmonary TB with the accuracy 96.1% (95%Cls 91.3-98.3), sensitivity
96,5% (95%Cls 90.1-98,8), specificity 95.6% (95%Cls 90.1-98.8), PPV 97.6% (95%Cls 91.7-99.3%), NPV of 93.5% ( (95%Cls 82.5- 97.8), LRP 21.7 (95%Cls 8.1-57.9) and LRN 0.04 (95%Cls 0.02- 0.07)compared to reference standard. Limited slice non-enhanced thoracic CT could also provide information regarding pulmonary abnormalities other than TB
Conclusion: Scoring system performed in limited slice non-enhanced thoracic CT has a highly comparable accuracy with the reference standard for the diagnosis of adult pulmonary TB
Keyword: Limited slice non enhanced thoracic CT, Scoring system, Adult pulmonary TB
Tumor di dalam toraks
No full textBuku ini menyajikan penarikan radiologi konvensional, tomografi komputer, MRI dari tumor yang ditemukan di dalam toraks.vi, 75 hlm.: ilus.; 24 c
Comparison of chest X-ray lesion characteristics of multidrug-resistant tuberculosis and non-tuberculous mycobacterial infection
Get PDFPurpose: This research aimed to compared chest radiographic characteristics of multidrug-resistant tuberculosis (MDR-TB) and non-tuberculous mycobacteria (NTM) infection, which can be used in early diagnostic screening. Material and methods: The method of this study was cross-sectional to obtain the relationship between radiographic findings. Results: Among 538 subjects who were positive for TB during screening, 11 (2.04%) had MDR-TB, 147 (27.32%) had drug-sensitive TB, and 380 (70.63%) had NTM infection. The radiographic findings that correlated with MDR-TB were infiltrates (p = 0.010), cavities (p = 0.021), nodules (p = 0.001), and fibrosis (p = 0.010), with the best predictor of MDR-TB lesions being the presence of a nodule. The lesion locations related to MDR-TB were the upper right and left lung (p = 0.00). There were no specific lesions present in NTM infection (p < 0.05) because almost all had a meaningful correlation (p < 0.05), except the presence of a mass. The lesion location related to NTM infection was the medial aspect of the left lung (p = 0.01), and the lesion extent was also correlated (p < 0.05). Conclusions: Chest X-ray lesion characteristics of MDR-TB show significant correlation among cavities, nodules, and fibrosis. There were no specific lesions that could differentiate NTM infection from MDR-TB; however, the most common lesion location in NTM infection was the medial aspect of the left lung
The accuracy of Aziza’s scoring system in limited slice non-enhanced thoracic CT for the diagnosis of adult pulmonary tuberculosis
Get PDFBackground: Tuberculosis (TB) is still a major cause of morbidity and mortality in Indonesia. Thus, a fast and accurate method in diagnosing pulmonary TB (PTB) is needed, especially in adult smear-negative-TB cases. The purpose of this study was to determine the accuracy of a novel scoring system (Aziza’s score) using clinical data and characteristic abnormalities that are found in the limited slice non-enhanced thoracic CT.Methods: This was a prospective cross-sectional study. A limited slice non-enhanced thoracic CT was performed to establish a diagnosis of PTB in patients with suspected PTB and to assess the diagnostic value of the scoring system. A reference standard used in this study was the clinical expertise of two pulmonologists. The scoring system was analyzed using bivariate and multivariate Cox regression analysis.Results: 84 of 130 suspected PTB patients were diagnosed as PTB. They were diagnosed based on pulmonary characteristic abnormalities that were found in the limited slice non-enhanced thoracic CT. The scoring system was analyzed using bivariate and multivariate Cox regression analysis. The total scores which were equal to or more than 29 could diagnose PTB with the accuracy of 96.1% (95% CIs=91.3–98.3), sensitivity of 96.5% (95% CIs=90.1–98.8), and specificity of 95.6% (95% CIs=90.1–98.8), This novel scoring method was name as an Aziza’s scoring system.Conclusion: Aziza’s scoring system performed in the limited slice non-enhanced thoracic CT has a higher accuracy compared to the reference standard for the diagnosis of adult PTB.</jats:p
Incidental detection of achalasia in a patient with dyspnea
No full textBackground: The absence of progressive peristalsis in the esophageal body and aberrant relaxation of the LES are two characteristics of achalasia, which is a main motility disease of the esophageal body and lower esophageal sphincter (LES). The most typical signs of achalasia are dysphagia and recurrent regurgitation.
Case report: We report a case of achalasia in a 54-year-old woman with the main complaint of dyspnea. Physical examination did not reveal any abnormalities. Chest x-ray results showed an enlarged upper mediastinal with air fluid level and superposition with the right border of the heart. The results of a chest computed tomography (CT) scan showed a dilated esophagus containing food material with air fluid levels. The patient then underwent an esophagostomy thoracotomy.
Discussion: Primary achalasia is associated with inflammatory degeneration of the inhibitory ganglion cells of the esophageal myenteric plexus and LES. Dysphagia, regurgitation, problems swallowing food, chest pain, heartburn, and weight loss are the most common symptoms. Barium esophagram is the best diagnostic test for achalasia with "Rat Tail" or “bird’s beak” appearance. CT scan examination is not only less invasive and painful, but also has high sensitivity for achalasia. In addition, CT scan are useful for differentiating primary and secondary achalasia and for diagnosing complications of achalasia.
Conclusion: Most cases of achalasia come with dysphagia, but some patients can come with respiratory problems or without complaints. CT scans can help identify achalasia in patients without complaints. Radiological examination plays an important role in detecting achalasia and reducing complications
Incidental detection of Tietze syndrome with costochondritis: A case report
No full textBackground: Tietze syndrome represents a rare and atypical source of anterior chest discomfort, distinguished by localized tenderness and non-suppurative swelling, typically centered around the 2nd or 3rd costal cartilages. Despite diligent investigation, the precise underlying causes of Tietze syndrome remain elusive.
Case Report: We present a case of a 35 year old male patient with suspected Tietze syndrome with costochondritis. He came in with complaints of abdominal pain and frequent coughs. He has a history of ADPKD and thalassemia since age 12. Tietze syndrome was an incidental finding in this patient. A thorax scan showed multiple nodular and lobulated lesions in the medial mediastinum; additionally, an abnormal widening and flattening of the costochondral junction of the ribs bilaterally. The CT scan findings reveal notable deformities characterized by widened and irregularly shaped anterior rib masses spanning the 1st to the 4th ribs bilaterally. The USG scan of the thorax showed a hypogenic thickening of the costochondral junction with vascularization.
Discussion: Tietze's syndrome presents a diagnostic challenge necessitating comprehensive imaging modalities for accurate diagnosis. Ultrasound imaging stands out as the primary approach, showcasing conspicuous soft tissue swelling indicative of the ongoing inflammatory process. While computed tomography often reveals subtle focal swellings or mild sclerosis in the affected joint.
Conclusion: The clinical manifestations frequently encompass an abrupt onset of chest discomfort devoid of antecedent trauma, predominantly observed among younger cohorts with an otherwise clean bill of health. Ultrasound is an accurate and effective modality to diagnose Tietze syndrome. This disease is frequently associated with other comorbidities such as rheumetic and autoimmune disorders
