scholarly journals Role of Transperineal Ultrasound (TPUS) in Children with Ambiguous Genitalia

Author(s):  
Krithika Rangarajan ◽  
Manisha Jana ◽  
Nagesh Wadgera ◽  
Arun Kumar Gupta ◽  
Minu Bajpai ◽  
...  

Abstract Objectives Accurate delineation of anatomy in children with ambiguous genitalia early in life is important. This commonly involves conventional fluoroscopic genitogram (traumatic to the child) and magnetic resonance imaging (MRI) examination (involves sedation). In this study, our objectives were twofold: (1) to describe the findings on transperineal ultrasound (TPUS) in normal children and (2) to describe the findings on TPUS in children with ambiguous genitalia and correlate them with conventional genitogram. Materials and Methods TPUS was prospectively performed in 10 children without genital ambiguity (5 girls and 5 boys). Subsequently, 15 consecutive children having disorders of sex differentiation (DSDs) with genital ambiguity underwent TPUS. The presence or absence of müllerian structures was documented. Of these patients, 14 also underwent conventional genitogram as a part of routine evaluation. The gold standard was established either by comparison with surgical findings (in patients who underwent surgery) or by comparison with a combination of findings on genitogram and transabdominal ultrasound in patients who did not undergo surgery. Results In all normal children, lower urogenital tracts could be clearly delineated on TPUS. Out of the 15 children with ambiguous genitalia, TPUS could establish the presence/absence of müllerian structures in 14. This was concordant with findings on conventional genitogram/surgery. In one patient, müllerian structure was missed on TPUS but demonstrated on genitogram. In two children, TPUS showed the müllerian structure, which was not seen on genitogram. When both the controls and the cases were combined, TPUS had an accuracy of 95% and specificity of 100% in the detection of müllerian structures. Conclusion TPUS is feasible and accurate in demonstration of lower urogenital tract anatomy in children with DSDs having ambiguous genitalia. It can be performed without sedation, and is suitable for use as a screening modality in children with ambiguous genitalia.

Author(s):  
  Нина Юрьевна Шокина ◽  
  Габриэль Тешнер ◽  
  Андреас Бауэр ◽  
  Камерон Тропеа ◽  
  Херберт Эггер ◽  
...  

Напряжение сдвига на стенке количественно определяет силу трения течения крови о стенки сосудов. Магнитнорезонансная томография (МРТ) позволяет проводить неинвазивные измерения скорости течения крови, которая требуется для вычисления напряжения сдвига на стенке. В статье представлено введение в квантификацию напряжения сдвига на стенках больших кровеносных сосудов с помощью МРТ. Рассмотрены роль напряжения сдвига на стенке как потенциального биомаркера сердечнососудистых заболеваний, сердечнососудистая МРТ, методы квантификации напряжения на стенке с помощью МРТ, их точность и валидация. В качестве примера представлен универсальный метод нелинейной регрессии для квантификации напряжения сдвига на стенке с помощью МРТ для полностью развившихся турбулентных течений в трубах. Новый, полностью автоматический и быстрый локальный метод даёт точные оценки независимо от пространственного разрешения и может служить надёжным эталонным методом для валидации более обобщённых методов оценки напряжения сдвига на стенке перед их клиническим применением. Wall shear stress (WSS) quantifies the frictional force that flowing blood exerts on a vessel wall. Magnetic Resonance Imaging (MRI) enables noninvasive measurements of blood flow velocities that are needed for WSS computation. An introduction into MRIbased WSS quantification in large blood vessels is presented. The possible role of WSS as a potential biomarker in cardiovascular diseases, cardiovascular MRI, MRbased WSS quantification methods, and their accuracy and validation are considered. As an example, the generic nonlinear regression method for MRIderived WSS quantification in fully developed turbulent stationary pipe flows is presented. The new method is a fully automatic and fast local WSS estimator, which produces accurate estimates independent from the spatial resolution of the measurement and may serve as a reliable reference for validation of more generic WSS estimators prior to their clinical applications.


2009 ◽  
Vol 19 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Vanessa N. Harry ◽  
Heather Deans ◽  
Emma Ramage ◽  
David E. Parkin ◽  
Fiona J. Gilbert

Magnetic resonance imaging (MRI) has become an indispensable tool in the assessment of malignant disease. With increasingly sophisticated systems and technical advancements, MRI has continued to expand its role in providing crucial information regarding cancer diagnosis and management. In gynecological malignancies, this modality has assumed greater responsibility, particularly in the evaluation of cervical and endometrial cancers. In addition to conventional imaging, innovative techniques such as dynamic contrast-enhanced MRI and diffusion-weighted MRI show promise in offering early assessment of tumor response. This paper reviews the current role of MRI in gynecological cancers and highlights the potential of novel techniques in improving patient care.


2017 ◽  
Vol 01 (04) ◽  
pp. E294-E306 ◽  
Author(s):  
Mike Wattjes ◽  
Peter Raab

AbstractMagnetic resonance imaging (MRI) plays an important role in the diagnosis of multiple sclerosis and has been incorporated into the McDonald diagnostic criteria for MS. In particular, for the exclusion of important differential diagnosis and comorbidities, new MRI markers have been established such as the “central vein sign”. In addition to diagnostic purposes, the role of MRI in MS monitoring is becoming increasingly important, particularly for pharmacovigilance. This includes treatment efficacy monitoring, prediction of treatment response and safety monitoring. Quantitative MRI methods and ultra-high-field MRI offer the opportunity for the quantitative assessment of damage in normal-appearing brain tissue. However, the standardization of these techniques with the goal of implementation in clinical routine will be one of the major challenges in the near future.


2009 ◽  
Vol 56 (3) ◽  
pp. 39-44
Author(s):  
R.M. Maksimovic ◽  
B.A. Banko ◽  
J.P. Milovanovic

Computed tomography (CT) and magnetic resonance imaging (MRI) are enabling more precise diagnosis and treatment planning in patients with diseases of the larynx. The aim of this article is to describe the role of these methods in assessment of the laringeal diseases and key local anatomic characteristics important for spread of the disease. CT and MRI have a valuable contribution to the staging of the tumors due to the possibility to show the relationship to the ventricular complex, involvement of the subumucosal spaces, defining craniocaudal and anterposterior extension, laringeal cartilage invasion, as well as regional lymph node metastases.


2003 ◽  
Vol 9 (6) ◽  
pp. 535-539 ◽  
Author(s):  
Tineke Hooper-van Veen ◽  
Hans M Schrijver ◽  
Antoon Zwiers ◽  
J Bart A Crusius ◽  
Dirk L Knol ◽  
...  

Multiple sclerosis (MS) is a chronic disease of presumed autoimmune origin with a considerable polygenic influence. We have previously observed that a specific allele combination in genes of the interleukin-1 (IL-1) family influenced the progression rate in MS. We have considerably expanded our patient population (492 MS patients and 228 controls). In the present study, we investigated the role of the IL- 1A - 889, IL-1B - 511, IL-1B+3953 and IL-1RN VNTR gene polymorphisms in MS. In addition, we performed preliminary analyses on longitudinal magnetic resonance imaging (MRI) data. We found no associations between the polymorphisms and susceptibility to MS or clinical features. In addition, we observed no significant effect of the polymorphisms on brain or lesion volumes, Based on our data and those from the literature, one can conclude that there is currently no evidence to support a role for the IL-1 genes in MS.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Paolo Petruzzelli ◽  
Roberto Zizzo ◽  
Elisabetta Tavassoli ◽  
Miriam Sutera ◽  
Michela Chiadò Fiorio Tin ◽  
...  

Colorectal cancer (CRC) during pregnancy presents an estimated incidence of 1 : 13,000, and it is associated with diagnostic and therapeutic challenges. Here, we present the case of a 38-year-old woman, 25 weeks and 5 days pregnant, who was transferred to our Obstetrics and Gynecology Department from a local hospital with the diagnosis of intestinal obstruction. Magnetic Resonance Imaging (MRI) showed marked distension with hydroaerial levels of the enterocolic loops upstream of a concentric parietal thickening of the descending colon, stenosing, extended longitudinally for about 4 cm. An exploratory laparotomy was performed with resection of the colon splenic flexure and mechanical end-terminal anastomosis. Histological examination of the operating piece highlighted the presence of moderately differentiated (G2) colon adenocarcinoma (stage pT3N1b). The operation was followed by a single course of oxaliplatin and 5-FU plus leukovorin. The patient had a vaginal delivery at 37   weeks + 2 days of gestational age, following induction of labor and giving birth to a male infant whose weight was 2670 gr with apgar 9/9. We underline the pivotal role of attention to unspecific symptoms, early diagnosis, and active treatment in changing the clinical course of CRC.


Genes ◽  
2020 ◽  
Vol 11 (7) ◽  
pp. 716
Author(s):  
Magdalena Mroczek ◽  
Hacer Durmus ◽  
Ana Töpf ◽  
Yesim Parman ◽  
Volker Straub

We identified the known c.1_9del mutation in the PLEC gene in four unrelated females from consanguineous families of Turkish origin. All individuals presented with slowly progressive limb-girdle weakness without any dermatological findings, and dystrophic changes observed in their muscle biopsies. Additionally, the neurological examination revealed ptosis, facial weakness, fatigability, and muscle cramps in all four cases. In two patients, repetitive nerve stimulation showed a borderline decrement and a high jitter was detected in all patients by single-fiber electromyography. Clinical improvement was observed after treatment with pyridostigmine and salbutamol was started. We further characterize the phenotype of patients with limb-girdle muscular dystrophy R17 clinically, by muscle magnetic resonance imaging (MRI) features and by describing a common 3.8 Mb haplotype in three individuals from the same geographical region. In addition, we review the neuromuscular symptoms associated with PLEC mutations and the role of plectin in the neuromuscular junction.


2020 ◽  
Vol 24 (02) ◽  
pp. 135-155
Author(s):  
Maria Pilar Aparisi Gómez ◽  
Costantino Errani ◽  
Radhesh Lalam ◽  
Violeta Vasilevska Nikodinovska ◽  
Stefano Fanti ◽  
...  

AbstractThe vast majority of soft tissue masses are benign. Benign lesions such as superficial lipomas and ganglia are by far the most common soft tissue masses and can be readily identified and excluded on ultrasound (US). US is an ideal triaging tool for superficial soft tissue masses. Compared with magnetic resonance imaging (MRI), High-resolution US is inexpensive, readily available, well tolerated, and safe. It also allows the radiologist to interact with the patient as a clinician. In this review, we describe and illustrate the lesions with typical (diagnostic) US features. When the appearances of the lesion are not typical as expected for a benign lesion, lesions are deep or large, or malignancy is suspected clinically, MRI and biopsy are needed. The management of suspicious soft tissue tumors has to be carefully planned by a multidisciplinary team involving specialized surgeons and pathologists at a tumor center.


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