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Doing More with Less: Diagnostic Accuracy of CT in Suspected Cauda Equina Syndrome

Overview of attention for article published in American Journal of Neuroradiology, October 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#41 of 3,452)
  • High Attention Score compared to outputs of the same age (92nd percentile)
  • High Attention Score compared to outputs of the same age and source (97th percentile)

Mentioned by

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43 tweeters
facebook
1 Facebook page

Citations

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4 Dimensions

Readers on

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12 Mendeley
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Title
Doing More with Less: Diagnostic Accuracy of CT in Suspected Cauda Equina Syndrome
Published in
American Journal of Neuroradiology, October 2016
DOI 10.3174/ajnr.a4974
Pubmed ID
Authors

J.G. Peacock, V.M. Timpone

Abstract

Cauda equina syndrome typically requires emergent MR imaging to detect compressive lesions on the cauda equina, which may require surgical decompression. While CT is sometimes performed as a complementary imaging technique to evaluate osseous integrity in patients with cauda equina syndrome, the accuracy of CT in detecting significant spinal stenosis and cauda equina impingement is not well-defined in the literature. We hypothesized that percentage thecal sac effacement on CT of the lumbar spine would have high sensitivity and high negative predictive value in evaluating significant spinal stenosis and cauda equina impingement. We analyzed imaging studies for 151 consecutive patients with clinically suspected cauda equina syndrome. The percentage thecal sac effacement (<50%, ≥50%) was determined on CT and MR imaging. The presence or absence of cauda equina impingement was determined on MR imaging. Using MR imaging as the reference standard, we performed statistical analysis to determine the accuracy of CT in predicting significant spinal stenosis (percentage thecal sac effacement, ≥50%) and cauda equina impingement. Forty of 151 patients had a percentage thecal sac effacement of ≥50% on MR imaging. Nineteen of 40 had cauda equina impingement. Readers determined that there was a CT percentage thecal sac effacement of <50% in 97/151 cases, and CT percentage thecal sac effacement of ≥50% in 54/151 cases. Reader sensitivity for the detection of significant spinal stenosis (MR percentage thecal sac effacement of ≥50%) was 0.98; specificity, 0.86; positive predictive value, 0.72; and negative predictive value, 0.99. No cases read as CT percentage thecal sac effacement of <50% were found to have cauda equina impingement. CT percentage thecal sac effacement of ≥50% predicts significant spinal stenosis on MR imaging in patients with clinically suspected cauda equina syndrome. CT percentage thecal sac effacement of <50% appears to reliably rule out cauda equina impingement. This imaging marker may serve as an additional tool for the clinician in deciding whether MR imaging can be deferred.

Twitter Demographics

The data shown below were collected from the profiles of 43 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 12 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 12 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 2 17%
Student > Doctoral Student 2 17%
Student > Bachelor 2 17%
Student > Postgraduate 2 17%
Researcher 1 8%
Other 3 25%
Readers by discipline Count As %
Medicine and Dentistry 7 58%
Unspecified 2 17%
Nursing and Health Professions 2 17%
Engineering 1 8%

Attention Score in Context

This research output has an Altmetric Attention Score of 31. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 November 2018.
All research outputs
#562,739
of 13,735,692 outputs
Outputs from American Journal of Neuroradiology
#41
of 3,452 outputs
Outputs of similar age
#19,962
of 257,360 outputs
Outputs of similar age from American Journal of Neuroradiology
#2
of 99 outputs
Altmetric has tracked 13,735,692 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,452 research outputs from this source. They receive a mean Attention Score of 4.6. This one has done particularly well, scoring higher than 98% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 257,360 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 99 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.