title: Diagnostic value of bent-lever planes in detecting abnormality of the malleus-incus complex.
abstract: OBJECTIVE
  To retrospectively investigate the diagnostic value of the bent-lever planes in detecting abnormality of the malleus-incus complex.
  
  
  METHODS
  Diagnostic test assessment.
  
  
  METHODS
  The study was conducted at the Shandong Medical Imaging Research Institute, Shandong University, Jinan, People's Republic of China.
  
  
  METHODS
  Eighty-five ears in 74 patients with surgically proved abnormality of the malleus-incus complex.
  
  
  METHODS
  The bent-lever planes and direct axial images were reviewed by 2 radiologists. The radiologists assigned a value of abnormality or continuity to different parts of the malleus-incus complex. Differences in categorical data were evaluated with the McNemar test. The sensitivity, specificity, Youden index, and interobserver agreement were calculated.
  
  
  RESULTS
  There was no significant difference between bent-lever planes and direct axial images in identifying abnormality of the malleus-incus complex. The sensitivity ranged from 71.4% to 97.1%, and specificity ranged from 89.5% to 100.0%. The Youden index ranged from 0.609 to 0.971. The radiologists had almost perfect or substantial agreement in identifying the abnormality of different parts of the malleus-incus complex.
  
  
  CONCLUSIONS
  The bent-lever planes do not add additional diagnostic value for experienced observers.
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Quan
authors.forename: Lebin
authors.initials: L
authors.lastname: Wu
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Li
authors.forename: Zushan
authors.initials: Z
authors.lastname: Xu
authors.forename: Ruozhen
authors.initials: R
authors.lastname: Gong
mesh_terms: D000465:Algorithms; D018424:Cholesteatoma, Middle Ear / Q000000981:diagnostic imaging / Q000601:surgery; D002908:Chronic Disease; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007188:Incus / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D008307:Malleus / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D008953:Models, Anatomic; D010033:Otitis Media / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013199:Stapes / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*