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Migration of the staple line is the definition of sliding hiatus hernia in sleeve gastrectomy patients. The main aim was to determine the frequency and measurement of intrathoracic staple line migration and its correlation with GERD symptoms and pH monitoring.This was a prospective clinical trial including all patients who underwent sleeve gastrectomy more than 1 year previously. All the patients underwent computed tomography (CT) imaging, and migration of the proximal end of the suture above the level of the hiatus was measured in mm. All the patients with symptoms suggestive of GERD were assessed using the GERD impact scale (GIS), and wireless 24-h esophageal pH and symptom association monitoring (SAP) were carried out. Analysis of risk factors for postoperative staple line migration was performed.Between March 2018 and December 2018, 194 patients were evaluated (mean age 45.1 ± 11.2 years; 161 females); 88/194 (45.4%) presented an average intrathoracic migration of 16.2 ± 6.9 mm. Thirty-eight of 194 (19.5%) patients presented symptoms suggestive of gastroesophageal reflux. There was a significant relationship between staple line intrathoracic migration and postsleeve GERD symptomatology (p = 0.0004, OR = 4.25 [1.92-9.39]). However, there was no significant correlation between positive 24-h pH monitoring and intrathoracic migration of the staple line (p = 0.1).A migration greater than 17 mm was strongly correlated with postsleeve GERD symptoms but not with positive 24-h pH monitoring.

Characterization of malignant cardiac masses is usually performed with cardiac magnetic resonance (CMR) and staging with whole-body contrast-enhanced computed tomography (CECT). In this study, our objective was to evaluate the role ofPatients with cardiac masses who underwent CMR, CECT, andIn a total of 28 patients (median age 60.5 years, 60.7% women), CMR accurately distinguished malignant from benign masses with sensitivity (Se) of 86.7%, specificity (Sp) of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 86.7%, and accuracy of 92.9%.Combining

The selection of patients for lung transplantation is difficult. An aspect of the patient's general condition and frailty can be assessed by measuring the surface area of certain muscles on CT. Indeed, sarcopenia, assessed by measuring the area of psoas muscles on scannographic sections has already been shown to be associated with poor outcomes in lung transplant and other major surgeries and could thus be helpful to evaluate candidates to lung transplant. However, it is not routinely performed by radiologists. As a pilot study, we compared the reliability of computerized tomography scan assessment for sarcopenia by clinicians with that of radiologists.We conducted a retrospective single-centre study in which preoperative abdominal CT scans of lung transplant patients from 2014 to 2018 were analysed to assess sarcopenia by measuring the surface areas (mmWe performed a double reading of 200 scans. The clinicians 'measurements were comparable to those of the radiologists for the psoas and paraspinal muscles but not for the diaphragm pillars.CT measurement of psoas and paraspinal muscle areas by clinicians appears reliable and feasible in routine practice and could be used in the evaluation of lung transplant candidates.

ObjectivesTo assess inter-observer agreement and clinical significance of chest CT reporting in patients suspected of COVID-19.MethodsFrom 16th to 24th March 2020, 241 consecutive patients addressed to hospital for COVID-19 suspicion had both chest CT and SARS-CoV-2 RT-PCR. Eight observers (2 thoracic and 2 general senior radiologists, 2 junior radiologists and 2 emergency physicians) retrospectively categorized each CT into one out of 3 categories (evocative, compatible for COVID-19 pneumonia, and not evocative or normal). Observer agreement for categorization between all readers and pairs of readers with similar experience was evaluated with the Kappa coefficient. The results of a consensus categorization were correlated to RT-PCR.ResultsObserver agreement across the 3 categories was good between all readers (κ value 0.68 95%CI 0.67-0.70) and good to very good between pairs of readers (0.64-0.85). It was very good (κ 0.81 95%CI 0.79-0.83), fair (κ 0.32 95%CI 0.29-0.34) and good (κ 0.74 95%CI 0.71-0.76) for the categories evocative, compatible and not evocative or normal, respectively. RT-PCR was positive in 97%, 50% and 27% of cases classified in the respective categories. Observer agreement was lower (p=0.045) and RT-PCR positive cases were less frequently categorized evocative in presence of an underlying pulmonary disease (pConclusionInter-observer agreement for chest CT reporting using categorization of findings is good in patients suspected of COVID-19. Among patients considered for hospitalization in an epidemic context, CT categorized evocative is highly predictive of COVID-19, whereas the predictive value of CT decreases between the categories compatible and not evocative.Key resultsInter-observer agreement for chest CT reporting into categories is good in patients suspected of COVID-19Chest CT can participate in estimating the likelihood of COVID-19 in patients presenting to hospital during the outbreak, CT categorized «evocative» being highly predictive of the disease whereas up to a quarter of patients with CT «not evocative» had a positive RT-PCR in our study.Observer agreement is lower and CTs of positive RT-PCR cases less frequently “evocative” in presence of an underlying pulmonary disease

International Journal of Advanced Research (IJAR)