rizwan aslam - Academia.edu (original) (raw)

Papers by rizwan aslam

Journal of Computer Assisted Tomography, 2008

Purpose-To determine the accuracy and interobserver agreement of spiral computed tomography (CT) ... more Purpose-To determine the accuracy and interobserver agreement of spiral computed tomography (CT) in the diagnosis of cirrhosis. Materials and Methods-We retrospectively identified 126 patients who underwent spiral CT at our institution and who had a contemporaneous histopathologic confirmation of cirrhosis (n = 67) or clinical and biochemical evidence of a normal liver (n = 59). Two experienced readers independently recorded the overall likelihood of cirrhosis and the presence or absence of hepatic and extrahepatic findings of cirrhosis and portal hypertension on a 5-point scale from 1 (definitely absent) to 5 (definitely present/severe). Results-Receiver operating characteristic curve and κ statistic analyses showed that the overall likelihood of cirrhosis was the most accurate and objective observation, with an area under the curve (AUC) of 0.97 for reader 1 and 0.90 for reader 2 and a κ value of 0.70. Individual findings that were accurate and objective were diaphragmatic surface nodularity (AUC = 0.95 and 0.88 for readers 1 and 2, respectively, κ = 0.75), global or segmental volume loss (AUC = 0.95 and 0.87 for readers 1 and 2, respectively, κ = 0.70), and superior diaphragmatic adenopathy (AUC = 0.85 for both readers, κ = 0.78). Of note, portal vein diameter was not significantly different between normal and cirrhotic patients as measured by either reader (P = 0.54 and 0.65). Conclusion-Spiral CT demonstrates high accuracy and interobserver agreement in the diagnosis of cirrhosis, suggesting CT may be a supplementary diagnostic test in patients who have contraindications to biopsy or have equivocal biopsy findings. Keywords cirrhosis; computed tomography Cirrhosis is a process of irreversible hepatic nodular regeneration and fibrosis and is the nonspecific result of repeated episodes of hepatocellular injury from a variety of causes including chronic viral hepatitis and exposure to toxins such as alcohol. Liver biopsy is generally and traditionally regarded as the reference standard for the diagnosis of cirrhosis, 1 but may yield false-negative results in up to one third of cases 2,3 and is an invasive procedure with a reported complication rate of 3.7%. 1,4 Given the limitations of biopsy, it is unsurprising

Otolaryngology - Head and Neck Surgery, 2007

Journal of Computer Assisted Tomography, 2008

Purpose-To determine the accuracy and interobserver agreement of spiral computed tomography (CT) ... more Purpose-To determine the accuracy and interobserver agreement of spiral computed tomography (CT) in the diagnosis of cirrhosis. Materials and Methods-We retrospectively identified 126 patients who underwent spiral CT at our institution and who had a contemporaneous histopathologic confirmation of cirrhosis (n = 67) or clinical and biochemical evidence of a normal liver (n = 59). Two experienced readers independently recorded the overall likelihood of cirrhosis and the presence or absence of hepatic and extrahepatic findings of cirrhosis and portal hypertension on a 5-point scale from 1 (definitely absent) to 5 (definitely present/severe). Results-Receiver operating characteristic curve and κ statistic analyses showed that the overall likelihood of cirrhosis was the most accurate and objective observation, with an area under the curve (AUC) of 0.97 for reader 1 and 0.90 for reader 2 and a κ value of 0.70. Individual findings that were accurate and objective were diaphragmatic surface nodularity (AUC = 0.95 and 0.88 for readers 1 and 2, respectively, κ = 0.75), global or segmental volume loss (AUC = 0.95 and 0.87 for readers 1 and 2, respectively, κ = 0.70), and superior diaphragmatic adenopathy (AUC = 0.85 for both readers, κ = 0.78). Of note, portal vein diameter was not significantly different between normal and cirrhotic patients as measured by either reader (P = 0.54 and 0.65). Conclusion-Spiral CT demonstrates high accuracy and interobserver agreement in the diagnosis of cirrhosis, suggesting CT may be a supplementary diagnostic test in patients who have contraindications to biopsy or have equivocal biopsy findings. Keywords cirrhosis; computed tomography Cirrhosis is a process of irreversible hepatic nodular regeneration and fibrosis and is the nonspecific result of repeated episodes of hepatocellular injury from a variety of causes including chronic viral hepatitis and exposure to toxins such as alcohol. Liver biopsy is generally and traditionally regarded as the reference standard for the diagnosis of cirrhosis, 1 but may yield false-negative results in up to one third of cases 2,3 and is an invasive procedure with a reported complication rate of 3.7%. 1,4 Given the limitations of biopsy, it is unsurprising

Otolaryngology - Head and Neck Surgery, 2007