Cargando…
Optimal diagnostic tool for surveillance of oesophageal varices during COVID-19 pandemic
AIM: To study the diagnostic accuracy and utility of triphasic abdominal computed tomography (CT) in the diagnosis and grading of oesophageal varices (OVs) as an alternative to endoscopy during the COVID-19 pandemic. MATERIALS AND METHODS: A prospective analysis was undertaken of retrospective data...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Published by Elsevier Ltd on behalf of The Royal College of Radiologists.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969836/ https://www.ncbi.nlm.nih.gov/pubmed/33820640 http://dx.doi.org/10.1016/j.crad.2021.02.029 |
_version_ | 1783666309760811008 |
---|---|
author | Jothimani, D. Danielraj, S. Nallathambi, B. Pandurangan, B. Kalyanasundaram, S. Subbiah, K. Ramachandran, H. Venugopal, R. Dhas, D. Rela, M. |
author_facet | Jothimani, D. Danielraj, S. Nallathambi, B. Pandurangan, B. Kalyanasundaram, S. Subbiah, K. Ramachandran, H. Venugopal, R. Dhas, D. Rela, M. |
author_sort | Jothimani, D. |
collection | PubMed |
description | AIM: To study the diagnostic accuracy and utility of triphasic abdominal computed tomography (CT) in the diagnosis and grading of oesophageal varices (OVs) as an alternative to endoscopy during the COVID-19 pandemic. MATERIALS AND METHODS: A prospective analysis was undertaken of retrospective data from cirrhotic patients who underwent oesophago-gastro-duodenoscopy (OGD) and a triphasic abdominal CT from January to December 2019. Endoscopists and radiologists provided their respective independent assessment of OV grading after being blinded to the clinical details. Performance of CT grading of OVs was compared with the reference standard endoscopic grading using weighted kappa (k). Non-invasive scores such, as aspartate transaminase (AST)-to-platelet ratio index (APRI), Fibrosis-4 (FIB-4) Index, platelet: spleen (PS) ratio were correlated between the two techniques. RESULTS: OV grading between endoscopists and radiologists showed 81.73% agreement (85 out of 104 patients) in the comparative analysis of 104 cirrhotic patients, of which no varices (57.1%, n=4), small (85.1%, n=23), medium (72.2%%, n=26), and large varices (94.1%, n=32) with a weighted k score of 0.88 (95% confidence interval 0.82–0.94). Overall, the sensitivity of CT in the diagnosis of no, small, medium, and large OVs was 66.6%, 79.3%, 89.6%, and 94.1%, respectively, with an area under the receiver operating curve (AUROC) score of 0.775, 0.887, 0.839, and 0.914. Performance of APRI, FIB-4, and PS ratio correlated well with the severity of OVs with no difference between OGD and CT grading. CONCLUSION: Triphasic abdominal CT can be an invaluable tool in the diagnosis and grading of OVs during the COVID-19 pandemic. |
format | Online Article Text |
id | pubmed-7969836 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Published by Elsevier Ltd on behalf of The Royal College of Radiologists. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79698362021-03-18 Optimal diagnostic tool for surveillance of oesophageal varices during COVID-19 pandemic Jothimani, D. Danielraj, S. Nallathambi, B. Pandurangan, B. Kalyanasundaram, S. Subbiah, K. Ramachandran, H. Venugopal, R. Dhas, D. Rela, M. Clin Radiol Article AIM: To study the diagnostic accuracy and utility of triphasic abdominal computed tomography (CT) in the diagnosis and grading of oesophageal varices (OVs) as an alternative to endoscopy during the COVID-19 pandemic. MATERIALS AND METHODS: A prospective analysis was undertaken of retrospective data from cirrhotic patients who underwent oesophago-gastro-duodenoscopy (OGD) and a triphasic abdominal CT from January to December 2019. Endoscopists and radiologists provided their respective independent assessment of OV grading after being blinded to the clinical details. Performance of CT grading of OVs was compared with the reference standard endoscopic grading using weighted kappa (k). Non-invasive scores such, as aspartate transaminase (AST)-to-platelet ratio index (APRI), Fibrosis-4 (FIB-4) Index, platelet: spleen (PS) ratio were correlated between the two techniques. RESULTS: OV grading between endoscopists and radiologists showed 81.73% agreement (85 out of 104 patients) in the comparative analysis of 104 cirrhotic patients, of which no varices (57.1%, n=4), small (85.1%, n=23), medium (72.2%%, n=26), and large varices (94.1%, n=32) with a weighted k score of 0.88 (95% confidence interval 0.82–0.94). Overall, the sensitivity of CT in the diagnosis of no, small, medium, and large OVs was 66.6%, 79.3%, 89.6%, and 94.1%, respectively, with an area under the receiver operating curve (AUROC) score of 0.775, 0.887, 0.839, and 0.914. Performance of APRI, FIB-4, and PS ratio correlated well with the severity of OVs with no difference between OGD and CT grading. CONCLUSION: Triphasic abdominal CT can be an invaluable tool in the diagnosis and grading of OVs during the COVID-19 pandemic. Published by Elsevier Ltd on behalf of The Royal College of Radiologists. 2021-07 2021-03-18 /pmc/articles/PMC7969836/ /pubmed/33820640 http://dx.doi.org/10.1016/j.crad.2021.02.029 Text en © 2021 Published by Elsevier Ltd on behalf of The Royal College of Radiologists. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Jothimani, D. Danielraj, S. Nallathambi, B. Pandurangan, B. Kalyanasundaram, S. Subbiah, K. Ramachandran, H. Venugopal, R. Dhas, D. Rela, M. Optimal diagnostic tool for surveillance of oesophageal varices during COVID-19 pandemic |
title | Optimal diagnostic tool for surveillance of oesophageal varices during COVID-19 pandemic |
title_full | Optimal diagnostic tool for surveillance of oesophageal varices during COVID-19 pandemic |
title_fullStr | Optimal diagnostic tool for surveillance of oesophageal varices during COVID-19 pandemic |
title_full_unstemmed | Optimal diagnostic tool for surveillance of oesophageal varices during COVID-19 pandemic |
title_short | Optimal diagnostic tool for surveillance of oesophageal varices during COVID-19 pandemic |
title_sort | optimal diagnostic tool for surveillance of oesophageal varices during covid-19 pandemic |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969836/ https://www.ncbi.nlm.nih.gov/pubmed/33820640 http://dx.doi.org/10.1016/j.crad.2021.02.029 |
work_keys_str_mv | AT jothimanid optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic AT danielrajs optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic AT nallathambib optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic AT panduranganb optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic AT kalyanasundarams optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic AT subbiahk optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic AT ramachandranh optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic AT venugopalr optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic AT dhasd optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic AT relam optimaldiagnostictoolforsurveillanceofoesophagealvaricesduringcovid19pandemic |