Correction to: Assessment of Psychosocial Functioning in a Large Cohort of Patients with Schizophrenia

Psychiatric Quarterly -     

Appendicolith revealed on CT in children with suspected appendicitis: how specific is it in the diagnosis of appendicitis?

OBJECTIVE. The purpose of this study was to determine the sensitivity, specificity, and positive and negative predictive values of a diagnosis of appendicitis when CT without enteric contrast material reveals an appendicolith in children with suspected appendicitis. MATERIALS AND METHODS. A retrospective review of children who underwent abdominal CT for suspected appendicitis over a 25-month period was performed to identify patients with an appendicolith. An age-matched group of patients examined for trauma served as controls. RESULTS. CT was performed in 104 children. Appendicitis was present in 60 (58%) of 104 children; 39 (65%) of 60 had an appendicolith. Appendicitis was not present in 44 (42%) of 104; six (14%) of 44 had an appendicolith. An appendicolith detected on CT had a sensitivity of 65% and a specificity of 86% for the radiologist diagnosing appendicitis. An appendicolith had a positive predictive value of 74% and a negative predictive value of 26%. Among the control population, two (3%) of 74 children had an appendicolith. This number was statistically significant compared with children in the study group with an appendicolith and abdominal pain, but without appendicitis (p = 0.02). CONCLUSION. Although an appendicolith is significantly associated with appendicitis, the detection of an isolated appendicolith on CT is not sufficiently specific to be the sole basis for the diagnosis of acute appendicitis.     

Bolus-chasing contrast-enhanced 3D MRA of the lower extremity. Comparison with intraarterial DSA

PURPOSE: To evaluate step-table 3D contrast-enhanced (CE) MRA with bolus chasing for the detection and grading of stenoses in patients with peripheral vascular disease (PVD) of the lower extremities. MATERIAL AND METHODS: Fifty patients were studied by step-table bolus-chasing 3D-CE-MRA and i.a. DSA within 24 h. After determination of the individual circulation time, CE-MRA was performed during power injection of 40 ml of Gd-DTPA. To cover the whole range between the renal arteries and the feet with three slab locations, the scanner table was manually advanced twice for 350 mm. Total imaging time was 1 min 23 s. The degree of stenosis and image quality of the images were evaluated by 2 observers. In addition, a treatment plan was established based on the 3D-CE-MRA and DSA investigations. RESULTS: In 44 of 50 patients (88%), the visualization of the arterial tree from the renal arteries to the foot was possible. Forty-six of 50 patients (92%) had good or very good image quality. In the calf, 3D-CE-MRA was superior to DSA in 6 patients. For the detection of stenosis >50%, sensitivity was 99.5%, specificity 98.8%, positive predictive value 95.6% and the negative predictive value 99.8%. Cohen's kappa for 3D-CE-MRA vs. DSA was 0.926; for interobserver agreement it was 0.96. CONCLUSION: Bolus-chasing 3D-CE-MRA with manual table movement is a simple, robust and easy to perform technique which provides high quality angiograms of the lower extremity arterial system and is comparable to, i.a., DSA for the diagnosis of PVD.