MDCT diagnosis of penetrating diaphragm injury
ABSTRACT The purpose of the study was to determine the diagnostic sensitivity and specificity of multidetector CT (MDCT) in detection of diaphragmatic injury following penetrating trauma. Chest and abdominal CT examinations performed preoperatively in 136 patients after penetrating trauma to the torso with injury trajectory in close proximity to the diaphragm were reviewed by radiologists unaware of surgical findings. Signs associated with diaphragmatic injuries in penetrating trauma were noted. These signs were correlated with surgical diagnoses, and their sensitivity and specificity in assisting the diagnosis were calculated. CT confirmed diaphragmatic injury in 41 of 47 injuries (sensitivity, 87.2%), and an intact diaphragm in 71 of 98 patients (specificity, 72.4%). The overall accuracy of MDCT was 77%. The most accurate sign helping the diagnosis was contiguous injury on either side of the diaphragm in single-entry penetrating trauma (sensitivity, 88%; specificity, 82%). Thus MDCT has high sensitivity and good specificity in detecting penetrating diaphragmatic injuries.
- SourceAvailable from: Mahdi Mohammadzadeh
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- "Orkan et al., as well, reported that CT scan and MRI findings were 100% diagnostic in both penetrating and blunt mechanisms (16). Bodanapally et al. with the use of multi-detector CT scanning reported promising results in penetrating diaphragmatic injuries, with sensitivity, specificity, and accuracy rates of 87%, 72%, and 77%, respectively (23). Therefore, computed tomography is the diagnostic test of choice in suspected patients with diaphragmatic hernia. "
ABSTRACT: Diaphragmatic hernia after blunt trauma is an uncommon and often undiagnosed condition. We aimed to review patients who presented with delayed blunt traumatic hernia of diaphragm. In this retrospective study, the medical records of six patients treated for blunt diaphragmatic hernias who were admitted to Kashan Shahid Beheshti hospital between June 2007 and June 2011 were analyzed. Six patients with mean age of 41 years were included in the study. Male to female ratio was 2:1. Mean duration between trauma and admission to the hospital was 6.5 years (2 - 26 years). Five patients had left-sided diaphragmatic hernia. Chest X-ray was obtained from all patients which was diagnostic in 50 percent of the cases (n = 4). Additional diagnostic imaging with computerized tomography (CT) was used in six patients and upper gastrointestinal (GI) contrast study was performed in one patient. All patients underwent thoracotomy incision. Mesh repair was utilized in one patient. The mean hospitalization time was 14.1 days. There was one postoperative death (16.7%). Late presentation of blunt diaphragmatic hernia is an uncommon and challenging situation for the surgeon. Prompt diagnosis and treatment prevent serious morbidity and mortality associated with complications such as gangrene and perforation of herniated organ.10/2012; 1(3):89-92. DOI:10.5812/atr.7593
Conference Paper: Bilateral control with a reflex mechanism on the slave side[Show abstract] [Hide abstract]
ABSTRACT: In this work, we are presenting a sliding mode controller approach for bilateral control. The controller consists of sliding mode force and hybrid (force/position) controllers for master and slave sides, respectively. Main issues such as transparency and time delay have been addressed in the derivation and the implementation of the controller. The approach takes the overall system (unified master and slave sides) as one system and therefore uses the transparency aims of the other approaches as the means for the derivation of the controller. It also makes use of a "reflex mechanism" to protect the slave side and its environment in case of large time delays, which disables the operator to react in time. The effectiveness of the proposed control scheme is evaluated experimentally and a maximum position error of one step increment of the encoder and a maximum torque error of 3×10<sup>-6</sup> Nm are achieved.Industrial Electronics Society, 2005. IECON 2005. 31st Annual Conference of IEEE; 12/2005
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ABSTRACT: Major chest trauma in a child is associated with significant morbidity and mortality. It is most frequently encountered within the context of multisystem injury following high-energy trauma such as a motor vehicle accident. The anatomic-physiologic make-up of children is such that the pattern of ensuing injuries differs from that in their adult counterparts. Pulmonary contusion, pneumothorax, haemothorax and rib fractures are most commonly encountered. Although clinically more serious and potentially life threatening, tracheobronchial tear, aortic rupture and cardiac injuries are seldom observed. The most appropriate imaging algorithm is one tailored to the individual child and is guided by the nature of the traumatic event as well as clinical parameters. Chest radiography remains the first and most important imaging tool in paediatric chest trauma and should be supplemented with US and CT as indicated. Multidetector CT allows for the accurate diagnosis of most traumatic injuries, but should be only used in selected cases as its routine use in all paediatric patients would result in an unacceptably high radiation exposure to a large number of patients without proven clinical benefit. When CT is used, appropriate modifications should be incorporated so as to minimize the radiation dose to the patient whilst preserving diagnostic integrity.Pediatric Radiology 05/2009; 39(5):485-496. DOI:10.1007/s00247-008-1093-5 · 1.57 Impact Factor