1.The Interobserver Agreement between Residents and Experienced Radiologists for Detecting Pulmonary Embolism and DVT with Using CT Pulmonary Angiography and Indirect CT Venography.
Ulas Savas YAVAS ; Cuneyt CALISIR ; Ibrahim Ragip OZKAN
Korean Journal of Radiology 2008;9(6):498-502
OBJECTIVE: We wanted to prospectively evaluate the interobserver agreement between radiology residents and expert radiologists for interpreting CT images for making the diagnosis of pulmonary embolism (PE). MATERIALS AND METHODS: We assessed 112 consecutive patients, from April 2007 to August 2007, who were referred for combined CT pulmonary angiography and indirect CT venography for clinically suspected acute PE. CT scanning was performed with a 64x0.5 collimation multi-detector CT scanner. The CT studies were initially interpreted by the radiology residents alone and then the CT images were subsequently interpreted by a consensus of the resident plus an experienced general radiologist and an experienced chest radiologist. RESULTS: Two of the 112 CTs were unable to be interpreted (1.7%). Pulmonary artery clots were seen on 36 of the thoracic CT angiographies (32%). The interobserver agreement between the radiology residents and the consensus interpretation was good (a kappa index of 0.73). All of the disagreements (15 cases) were instances of overcall by the resident on the initial interpretation. Deep venous thrombosis was detected in 72% (26 of 36) of the patients who had PE seen on thoracic CT. The initial and consensus interpretations of the CT venography images disagreed for two cases (kappa statistic: 0.96). CONCLUSION: It does not seem adequate to base the final long-term treatment of PE on only the resident's reading, as false positives occurred in 13% of such cases. Timely interpretation of the CT pulmonary angiography and CT venography images should be performed by experienced radiologists for the patients with suspected PE.
Adult
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Aged
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Aged, 80 and over
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Female
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Humans
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Male
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Middle Aged
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Observer Variation
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*Phlebography
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Pulmonary Artery/*radiography
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Pulmonary Embolism/*radiography
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*Tomography, X-Ray Computed
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Venous Thrombosis/*radiography
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Young Adult
2.The Relationship between the Breast Arterial Calcification Detected by Mammography and the Hypertensive Retinopathy in Hypertensive Women.
Cuneyt CALISIR ; Ulas Savas YAVAS ; Nazmiye EROL
Korean Journal of Radiology 2008;9(4):320-324
OBJECTIVE: The purpose of this study was to investigate the relationship between the breast arterial calcification (BAC) detected by mammograms and the hypertensive retinopathy (HR) in hypertensive women who underwent ophthalmologic examination. MATERIALS AND METHODS: Screening mammography was performed in 99 hypertensive women and these women also underwent an ophthalmologic examination. The presence of arterial calcification and the number of calcified blood vessels in each breast were evaluated. The grade of HR was determined. The presence of BAC and the number of blood vessels involved was compared according to the presence of HR and the grade of HR. RESULTS: Among the 99 patients, HR was detected in 70 patients, and of these 70 patients, 42 patients had grade I HR and 28 had grade II HR. BAC was detected in 54 cases. Forty-six patients with HR (66%) and eight patients without HR (27%) were diagnosed with BAC after they underwent mammographic examination. The prevalence of BAC in the subjects who had HR was statistically higher than that in those subjects who did not have HR (p < 0.01). The grade of HR was not significantly associated with BAC (p > 0.05). The positive predictive value of the BAC detected on mammography for HR was 0.80 in those subjects who were > or = 60 years old. CONCLUSION: The detection of BAC by mammography is associated with an increased risk of HR, and particularly for patients after the age of 60. The findings of BAC may be related to hypertensive end-organ damage, and performing mammograms might contribute to predicting the presence of ophthalmologic hypertensive complications in these patients.
Adult
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Age Factors
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Aged
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Arteries/pathology
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Breast/*blood supply
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Calcinosis/*complications
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Female
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Humans
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Hypertension/*complications
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Mammography
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Middle Aged
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Retinal Diseases/*complications
3.Mazabraud's Syndrome Coexisting with a Uterine Tumor Resembling an Ovarian Sex Cord Tumor (UTROSCT): a Case Report.
Cuneyt CALISIR ; Ulukan INAN ; Ulas Savas YAVAS ; Serap ISIKSOY ; Tamer KAYA
Korean Journal of Radiology 2007;8(5):438-442
The association of intramuscular myxoma and fibrous dysplasia is a rare disease known as Mazabraud's syndrome. We present a case of Mazabraud's syndrome coexisting with a uterine tumor and resembling an ovarian sex cord tumor (UTROSCT). This uterine tumor showed a high mitotic index and cytological atypia. To the best of our knowledge, the coexistence of the two different entities has not been reported in the literature.
Aged
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Biopsy
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Buttocks/pathology/surgery/ultrasonography
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Diagnosis, Differential
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Female
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Fibrous Dysplasia, Monostotic/complications/*diagnosis/surgery
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Humans
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Magnetic Resonance Imaging
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Myxoma/complications/*diagnosis/surgery
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Ovarian Neoplasms/*diagnosis
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Rare Diseases
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Sex Cord-Gonadal Stromal Tumors/*diagnosis
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Syndrome
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Uterine Neoplasms/complications/*diagnosis/surgery