scholarly journals Magnetic resonance imaging classification of deep pelvic endometriosis: description and impact on surgical management

2020 ◽  
Vol 35 (7) ◽  
pp. 1589-1600 ◽  
Author(s):  
Isabelle Thomassin-Naggara ◽  
Samia Lamrabet ◽  
Adrien Crestani ◽  
Asma Bekhouche ◽  
Cendos Abdel Wahab ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Voiding Dysfunction ◽  
Operating Time ◽  
Pelvic Endometriosis ◽  
Rectovaginal Septum ◽  
Mri Findings ◽  
Number Of Patients ◽  
Radiological Classification ◽  
Deep Pelvic Endometriosis

Abstract STUDY QUESTION Is an MRI classification of deep pelvic endometriosis (DE) able to correctly predict the risk of DE surgery. SUMMARY ANSWER A new radiological classification, that we have called the deep pelvic endometriosis index (dPEI) classification, is accurate and reproducible to assess the extension of the disease in central and lateral compartments and well correlated with operating time, hospital stay duration and the risk of voiding dysfunction. WHAT IS KNOWN ALREADY Few imaging classifications are currently available to predict the extent of DE to help preoperative assessment of surgical outcomes and provide the patient with objective information about the risk of surgical complications. STUDY DESIGN, SIZE, DURATION Retrospective monocentric observational study was conducted between 01 January 2017 and 31 December 2018 and included 150 women (mean age = 34.5 years, 20–52 years) with DE on MRI and who subsequently underwent surgery. PARTICIPANTS/MATERIALS, SETTING, METHODS Two radiologists independently graded the disease according to MRI-based Enzian classification (A (rectovaginal septum and vagina locations), B (uterosacral locations) and C (rectosigmoid locations)) and a new radiological classification, that we have called the dPEI, that grades the severity of DE as: mild, moderate or severe DE. MRI findings and classification were correlated with surgical and pathological results. MAIN RESULTS AND THE ROLE OF CHANCE MRI-based and surgical Enzian classifications were concordant for A lesions in 78.7% (118/150), for B lesions in 34.7% (52/150) and for C lesions in 82.7% (124/150). Operating time and hospital stays were longer in Group A2 (rectovaginal septum and vagina, 1–3 cm) compared to A0, B2 (uterosacral, 1–3 cm) compared to B0, C3 (rectosigmoid >3 cm) compared to C2 (rectosigmoid 1–3 cm) or C0 (P < 0.001), in severe compared to moderate DE patients, and in moderate compared to mild extensive patients (P < 0.01). Patients with vaginal or rectosigmoid involvement were respectively six and three times more likely to experience high-grade complications according to Clavien–Dindo classification than patients without vaginal or rectosigmoid disease (P < 0.001). Postoperative voiding dysfunction was correlated with A lesions (odds ratio (OR) = 6.82, 95% CI 2.34–20.5), moderate or severe DE (OR = 4.15, 95% CI 1.26–17.9), the presence of at least unilateral lateral pelvic involvement (OR = 3.6, 95% CI 1.14–11.2, P = 0.03) and C lesions (OR = 2.6, 95% CI 1.03–6.8, P < 0.01). LIMITATIONS, REASONS FOR CAUTION The study was conducted in an expert center and needs to be validated in a multicenter study. There is a limited number of patients with lateral pelvic endometriosis beyond the parietal fascia, probably due to the low prevalence of this disease presentation. WIDER IMPLICATIONS OF THE FINDINGS MRI imaging can be used to accurately predict postoperative complications for women with DE. This may help the clinician to preoperatively inform a patient about the risks of surgery. Larger clinical studies are required to validate these results. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used for this study. I.T.N.: Remunerated lecture GE, Hologic, Guerbet, Canon; Advisory board: Siemens - These relationships are on the topic of breast imaging, not related to the topic of this paper. Other coauthors have no conflict of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.

MRI analysis and surgical treatment of Wassel Type IV duplicated thumbs

2021 ◽  
pp. 175319342098321
Author(s):  
Anyuan Wang ◽  
Jian Ding ◽  
Long Wang ◽  
Tinggang Chu ◽  
Zhipeng Wu ◽  
...  
Keyword(s):  
Type A ◽  
Surgical Reconstruction ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Type D ◽  
Type Iv ◽  
Secondary Operations ◽  
Type C

We present the MRI findings for 39 Wassel Type IV duplicated thumbs in 38 patients. We found that MRI revealed the morphology of the cartilaginous connection between the thumb anlages and the location of the deviation corresponding to the classification of Horii, which allowed precise preoperative planning of corrective osteotomies. All 39 thumbs were available for follow-up after surgical reconstruction at a mean of 29 months (range 25 to 39). Four out of nine Horii Type A cases and all 12 Type B, as well as the six Type C and the six Type D cases, achieved good results according to the Tada scoring system. Five Type A cases achieved fair results with residual stiffness of the interphalangeal joint. No secondary operations were needed. We conclude that MRI proved useful in subclassifying Wassel Type IV duplicated thumbs and may aid in planning the osteotomies needed for their reconstruction. Level of evidence: IV

Epiphyseal bone-marrow abnormalities and restitution in legg-calvé-perthes disease

1997 ◽  
Vol 38 (5) ◽  
pp. 855-862 ◽  
Author(s):  
P. Hochbergs ◽  
G. Eckervall ◽  
H. Wingstrand ◽  
N. Egund ◽  
K. Jonsson
Keyword(s):  
Bone Marrow ◽  
Mr Imaging ◽  
Perthes Disease ◽  
Mr Images ◽  
Group I ◽  
Radiological Classification ◽  
Signal Changes ◽  
Over Time ◽  
Epiphyseal Bone

Purpose: By means of MR imaging, to determine signal abnormalities in the femoral epiphysis; to determine their location, extent and restitution over time; and to correlate these findings to the Catterall radiological classification. Material and Methods: A total of 247 MR images in 86 patients (101 hips) with Legg-CalvC-Perthes disease were examined. The MR images were taken in the coronal plane, and the images through the center of the femoral head were used for this study. Results: T1-weighted images proved as good as T2-weighted images for the MR evaluation of the extent of the necrosis. In almost every case, the central-cranial part of the epiphysis showed a low initial signal. In Catterall group I, the medial part was never involved. In Catterall III and IV, almost the entire epiphysis showed signal changes. In the period 3–6 years after diagnosis, we still found signal changes in the epiphysis in some hips but there was no correlation with the Catterall classification. After 6 years, the epiphysis showed normal signal intensity in MR imaging. In T1-weighted images, Gd-enhancement occurred in the peripheral regions in the early stages of the disease. The central part of the epiphysis became more enhanced over time and peaked in the period 1–3 years after diagnosis. Conclusion: MR is a valuable modality for monitoring changes in the femoral epiphysis. We propose a new classification of the extent and pattern of epiphyseal bone-marrow abnormalities based on the 4 zones most commonly observed in MR imaging.

The echo-logic for deep pelvic endometriosis

2002 ◽  
Vol 9 (3) ◽  
pp. S74 ◽  
Author(s):  
PAG Ribeiro ◽  
RA Almeida-Prado ◽  
T Aoki ◽  
N Donadio ◽  
TA Ferreira ◽  
...  
Keyword(s):  
Pelvic Endometriosis ◽  
Deep Pelvic Endometriosis

scholarly journals Correlation between Campanacci’s radiological classification of giant cell tumor of bone and expression of Cyclin D1 and PCNA

2017 ◽  
Vol 7 (1) ◽  
pp. 47
Author(s):  
Eréndira G. Estrada-Villaseñor ◽  
Hidalgo Bravo Alberto ◽  
C. Bandala ◽  
P. De la Garza-Montano ◽  
Reyes Medina Naxieli ◽  
...  
Keyword(s):  
Cyclin D1 ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Descriptive Study ◽  
Cell Tumor ◽  
Giant Cell Tumors ◽  
Radiological Classification ◽  
Tumors Of Bone ◽  
Made In

Giant cell tumor of bone is considered by his behavior a benign but aggressive neoplasm. The objective of our study was to determine if there is a correlation between the Campanacci’s radiological classification of giant cell tumors of bone and the expression by immunohistochemistry of Cyclin D1 and proliferation cell nuclear antibody (PCNA). A retrospective and descriptive study was made. In total, there were 27 cases. All cases showed Cyclin D1 and PCNA positivity. Rho Spearman for Campanacci and Cyclin D1 expression was 0.06 and for Campanacci and PCNA was 0.418. We conclude that there is a positive correlation between PCNA expression in giant cell tumors of Bone and the Campanacci’s radiological classification II and III, butCyclin D1 expression was no related with radiologic features.

Nerve sparing in the treatment of deep pelvic endometriosis: Is it worth it?

2004 ◽  
Vol 11 (3) ◽  
pp. S5-S6 ◽  
Author(s):  
PA Ayroza Galvao Ribeiro ◽  
HSA Silveira ◽  
G Kamergorodsky ◽  
NB Lemos ◽  
RA Almeida-Prado ◽  
...  
Keyword(s):  
Nerve Sparing ◽  
Pelvic Endometriosis ◽  
Deep Pelvic Endometriosis

scholarly journals Non-specific diagnoses are frequent in patients hospitalized after calling 112 and their mortality is high – a register-based Danish cohort study

2020 ◽  
Author(s):  
Frederikke Vestergaard Nielsen ◽  
Mette Rønn Nielsen ◽  
Ida Lund Lorenzen ◽  
Jesper Amstrup ◽  
Torben Anders Kløjgaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
International Classification Of Diseases ◽  
Rank Test ◽  
Test Results ◽  
Historical Cohort ◽  
Specific Diagnosis ◽  
Number Of Patients ◽  
Classification Of Diseases ◽  
Icd 10

Abstract Background The number of patients calling for an ambulance increases. A considerable number of patients receive a non-specific diagnosis at discharge from the hospital, and this could imply less serious acute conditions, but the mortality has only scarcely been studied. The aim of this study was to examine the most frequent sub-diagnoses among patients with hospital non-specific diagnoses after calling 112 and their subsequent mortality. Methods A historical cohort study of patients brought to the hospital by ambulance after calling 112 in 2007-2014 and diagnosed with a non-specific diagnosis, chapter R or Z, in the International Classification of Diseases, 10 th edition (ICD-10). 1-day and 30-day mortality was analyzed by survival analyses and compared by the log-rank test. Results We included 74,847 ambulance runs in 53,937 unique individuals. The most frequent diagnoses were ‘unspecified disease’ (Z039), constituting 47.0 % (n 35,279). In children 0-9 years old, ‘febrile convulsions’ was the most frequent non-specific diagnosis used in 54.3 % (n 1,602). Overall, 1- and 30-day mortality was 2.2 % (n 1,205) and 6.0 % (n 3,258). The highest mortality was in the diagnostic group ‘suspected cardiovascular disease’ (Z035) and ‘unspecified disease’ (Z039) with 1-day mortality 2.6 % (n 43) and 2.4 % (n 589), and 30 day mortality of 6.32 % (n 104) and 8.1 % (n 1,975). Conclusion Among patients calling an ambulance and discharged with non-specific diagnoses the 1- and 30-day mortality, despite modest mortality percentages lead to a high number of deaths.

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