Transvaginal Sonographic Imaging and Associated Techniques for Diagnosis of Ovarian, Deep Endometriosis, and Adenomyosis: A Comprehensive Review

2020 ◽  
Vol 38 (02/03) ◽  
pp. 216-226
Author(s):  
Mee Kristine Aas-Eng ◽  
Eliana Montanari ◽  
Marit Lieng ◽  
Joerg Keckstein ◽  
Gernot Hudelist
Keyword(s):  
Tertiary Care ◽  
Transvaginal Sonography ◽  
Imaging Method ◽  
First Line ◽  
Deep Endometriosis ◽  
Delay In Diagnosis ◽  
Line Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Ovarian Endometriomas ◽  
Sonographic Imaging

AbstractImaging of endometriosis and in particular deep endometriosis (DE) is crucial in the clinical management of women facing this debilitating condition. Transvaginal sonography (TVS) is the first-line imaging method and magnetic resonance imaging (MRI) may provide supplemental information. However, the delay in diagnosis of up to 10 years and more is of concern. This problem might be overcome by simple steps using imaging with emphasis on TVS and referral to tertiary care. Finally, TVS is crucial in mapping extent and location of disease in planning surgical therapy and counseling women regarding various therapeutic options. This review presents the available data on imaging of endometriosis with a focus on TVS and MRI for DE, adenomyosis, and ovarian endometriomas including endometriomas in pregnancy as well as the use of “soft markers.” The review presents an approach that is in accordance with the International Deep Endometriosis Analysis (IDEA) group consensus statement.

Pulley, Flexor, and Extensor Tendon Injuries of the Hand

2021 ◽  
Vol 25 (02) ◽  
pp. 203-215
Author(s):  
Andrea B. Rosskopf ◽  
Mihra S. Taljanovic ◽  
Luca M. Sconfienza ◽  
Salvatore Gitto ◽  
Carlo Martinoli ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
Resonance Imaging ◽  
First Line ◽  
A2 Pulley ◽  
Dynamic Examination ◽  
Line Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Extensor Tendon Injuries

AbstractTendon injuries represent the second most common injury of the hand (after fractures) and are a common scanning indication in radiology. Pulley injuries are very frequent in rock climbers with the A2 pulley the most commonly affected. Tendon and pulley injuries can be reliably evaluated using ultrasound (US) and magnetic resonance imaging (MRI). US can be postulated as a first-line imaging modality, allowing dynamic examination. MRI is essential for cases with ongoing diagnostic doubt post-US and also for preoperative pulley reconstruction assessment.

scholarly journals Clinical and ultrasound characteristics of virilizing ovarian tumors in pre- and postmenopausal patients: a single tertiary center experience

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mi Zou ◽  
Rong Chen ◽  
Yahong Wang ◽  
Yonglan He ◽  
Ying Wang ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Serum Testosterone ◽  
Ovarian Tumors ◽  
Imaging Method ◽  
First Line ◽  
College Hospital ◽  
Medical College ◽  
Tertiary Center ◽  
Line Imaging ◽  
Endocrine Symptoms

Abstract Background A virilizing ovarian tumor (VOT) is a rare cause of hyperandrogenism in pre- and postmenopausal women. Although transvaginal ultrasound is considered as the first-line imaging method for ovarian tumors, it is examiner-dependent. We aimed to summarize the clinical and ultrasound manifestations of VOTs to help establish the diagnosis with emphasis on those causing diagnostic difficulty. Method We retrospectively identified 31 patients with VOTs who underwent surgery at Peking Union Medical College Hospital. Results Patients with VOTs were predominantly premenopausal. All patients showed androgenic manifestations with serum testosterone levels elevated to varying degrees. The tumor size of VOTs was significantly correlated with age (P < 0.001). The VOTs in the postmenopausal group were significantly smaller than those in the premenopausal group (median 1.8 cm [range, 1.3–4.8 cm] vs 4.5 cm [range, 0.7–11.9 cm]; P = 0.018). Twenty-seven out of 31 VOTs were successfully identified by ultrasound. On ultrasound, VOTs are mostly solid and hypoechoic masses with enhanced vascularity. Four VOTs (0.7–1.5 cm) were radiologically negative, and they were the smallest among all patients. Conclusion Patients with VOTs showed androgenic manifestations with varying degrees of hyperandrogenemia. Older patients tend to have smaller VOTs. Ultrasound is an effective method for the detection of VOTs. Some VOTs can be very small and difficult to visualize radiologically, especially in postmenopausal patients. Examiners must remain vigilant about very small VOTs on the basis of endocrine symptoms.

scholarly journals Characterization of Focal Liver Lesions using Contrast Enhanced Ultrasound as a First Line Method: a Large Monocentric Experience

2014 ◽  
Vol 23 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Ioan Sporea ◽  
Alina Martie ◽  
Simona Bota ◽  
Roxana Sirli ◽  
Alina Popescu ◽  
...  
Keyword(s):  
Focal Liver Lesions ◽  
Imaging Method ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
First Line ◽  
Clear Cut ◽  
Contrast Enhanced ◽  
Line Imaging ◽  
Conclusive Diagnosis

Aim: To present a large monocentric experience in the characterization of focal liver lesions (FLLs) using Contrast Enhanced Ultrasound (CEUS).Method: A retrospective study was performed in the Gastroenterology and Hepatology Department, Timisoara, including 1100 patients with 1329 FLLs evaluated between September 2009 and January 2013. A CEUS examination was considered conclusive if the FLL respected the typical enhancement pattern as described in the EFSUMB Guidelines.Results: From the 1329 FLLs, CEUS was conclusive for a specific pathology in 1102 cases (82.9%). For the differentiation of benign/malignant lesions, CEUS reached a conclusive diagnosis in 1196 (90%) cases. The percentage of conclusive CEUS examinations was significantly higher in patients without chronic liver disease as compared with those with chronic hepatopathies: 87.3% vs. 74.4% (p<0.0001).Conclusion: CEUS patterns of enhancement fell into clear cut specific diagnostic patterns in 83% of the FLLs discovered by US, and into clear cut benign versus malignant patterns in 90% of the cases. For this reason, we can strongly recommend CEUS as a first line imaging method to characterize FLLs found at US, at least in centers with a good experience in CEUS.

Ultrasound Diagnosis of Pelvic Endometriosis

2011 ◽  
Vol 3 (2) ◽  
pp. 105-119
Author(s):  
Antonio Maiorana ◽  
Domenico Incandela ◽  
Laura Giambanco ◽  
Walter Alio ◽  
Luigi Alio
Keyword(s):  
Imaging Techniques ◽  
Diagnostic Technique ◽  
Ultrasound Diagnosis ◽  
Transvaginal Sonography ◽  
Anatomical Location ◽  
Deep Infiltrating Endometriosis ◽  
Pelvic Endometriosis ◽  
First Line ◽  
Intestinal Endometriosis ◽  
Deep Endometriosis

Purpose Endometriosis remains a challenging condition for clinicians, research scientists, and patients alike. Routine clinical examination is insufficient to diagnose and evaluate the extent of pelvic endometriosis which can be assessed by means of imaging techniques, including transvaginal sonography (TVS), transrectal sonography (TRS), rectal endoscopic sonography (RES), and magnetic resonance imaging (MRI). Our purpose was to analyze the different imaging techniques and their efficacy for the ultrasound diagnosis of pelvic endometriosis. Materials and methods This review examined 85 studies on the ultrasound diagnosis of endometriosis published between 2005 and 2010. The structure of the review is based first on the anatomical location of the endometriosis lesion, and then on the study of the techniques used, including transvaginal sonography, transrectal sonography, rectal endoscopic sonography, and MRI. Results TVS is the first-line imaging technique for diagnosing pelvic endometriosis. Many studies have demonstrated that sensitivities and specificities of TVS for diagnosing endometriomas range from 75% to 91% and 88% to 99%, respectively, while for RES the percentages are 88% and 90%, respectively, for the diagnosis of intestinal endometriosis. TVS and RES can correctly diagnose posterior deep infiltrating endometriosis (DIE) with an accuracy of 86.4% and 74.1%, respectively. Conclusions The analysis of these results show that ultrasound is the first-line diagnostic technique for the diagnosis of pelvic endometriosis. RES can help to identify the presence and the degree of wall infiltration of bowel sites. However, in patients with a consistent clinical suspicion of deep endometriosis, MRI is a good “all in one” examination to diagnose and define the exact extent of DIE.

scholarly journals Orbital Subperiosteal Hematoma in the Newborn Causing Unilateral Proptosis: Ultrasound as First-Line Imaging Modality

2017 ◽  
Vol 07 (02) ◽  
pp. e138-e143 ◽  
Author(s):  
Florencia Angkasa ◽  
Leila Mohammadi ◽  
Deepa Taranath ◽  
Ajay Taranath ◽  
Marcus Brecht
Keyword(s):  
Imaging Modality ◽  
Ultrasound Images ◽  
First Line ◽  
Common Causes ◽  
Line Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Management Approaches ◽  
Unilateral Proptosis ◽  
Orbital Hematoma

Proptosis in the neonatal period is relatively infrequent and has diverse underlying etiologies. One of the more common causes appears to be orbital subperiosteal hematoma. Early detection, differentiation from other causes, and regular follow-up are essential as loss of vision can occur. We describe two cases of neonatal proptosis caused by orbital subperiosteal hematoma highlighting different diagnostic and management approaches, and provide a summary of previously reported cases. Spontaneous resolution occurs in most cases; however, emergent surgical evacuation is warranted in cases of optic nerve compression. This is the first report to provide orbital ultrasound images of uncomplicated neonatal orbital subperiosteal hematoma. Orbital ultrasound followed by magnetic resonance imaging (MRI) is a valid nonradiation approach for assessing neonatal proptosis due to subperiosteal orbital hematoma.

Imaging in Nontraumatic Pediatric Head and Neck Emergencies

2017 ◽  
Vol 15 (05) ◽  
pp. 263-293
Author(s):  
Meghna Chadha ◽  
Zhiyun Yang ◽  
Shehanaz Ellika
Keyword(s):  
Head And Neck ◽  
Pediatric Patients ◽  
Imaging Modality ◽  
Emergency Setting ◽  
Resonance Imaging ◽  
First Line ◽  
Neoplastic Lesions ◽  
Line Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Fascial Spaces

AbstractPediatric patients often present to the emergency department with a wide variety of infectious, inflammatory, and neoplastic lesions of the head and neck. Evaluation of pediatric patients in the emergency setting is complicated by limited history and physical examination. Imaging plays an important role in arriving at an accurate diagnosis. The fascial spaces and compartments of the neck provide an approach to differential diagnosis, and knowledge of the typical clinical and imaging manifestations of common pediatric head and neck emergencies allows the radiologist to identify the condition and associated complications that may require emergent surgical management. Computed tomography (CT) is the first-line imaging modality in the emergency setting; however, magnetic resonance imaging (MRI) plays an important secondary role.

scholarly journals LARGE OVARIAN CYSTADENOMA HERNIATING THROUGH A PARA-UMBILICAL HERNIA :A CASE REPORT

2021 ◽  
Vol 9 (03) ◽  
pp. 188-191
Author(s):  
Akarramou A ◽  
◽  
Khalloufi C ◽  
Mourabbih M ◽  
Mahdaoui S ◽  
...  
Keyword(s):  
Case Report ◽  
Umbilical Hernia ◽  
Unusual Case ◽  
Transvaginal Sonography ◽  
Significant Morbidity ◽  
Abdominal Organ ◽  
First Line ◽  
Surgical Exploration ◽  
Line Imaging ◽  
Small And Large Intestine

Introduction: Incisional hernia or eventration is a frequent complication that affects approximately 10 to 25% of the patients after a laparotomy. These hernias must be repaired because of their significant morbidity. The usual hernial content is the omentum and intestines, the incarceration of other abdominal structures, such as the genitals, is very rare. Observation: We present an unusual case of a large ovarian cystadenoma herniating through a para-umbilical hernia, resection led to full recovery. Discussion: Large para-umbilical hernias are usually irreducible and incarcerated. Omentum, small and large intestine are commonly encountered in these hernias. By reviewing the literature, we found that incarceration of other abdominal structures is quite rare. Thus the transvaginal sonography is the first-line imaging, we may usually need further investigations such as CT, MRI or even surgical exploration, to avoid any unnecessary delay. Conclusion: In conclusion, para-umbilical hernia in adults can be the site of the incarceration of any abdominal organ and urgent exploration is recommended in these cases.

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