MODERN ASPECTS OF ULTRASOUND DIAGNOSIS OF ENDOMETRIOID HETEROTOPIAS OF PELVIC CAVITY ORGANS

2020 ◽  
pp. 87-92
Author(s):  
A. S. Novikova ◽  
I. Yu. Kuzmina
Keyword(s):  
Transvaginal Ultrasound ◽  
Clinical Signs ◽  
Transvaginal Ultrasonography ◽  
Transvaginal Sonography ◽  
Pelvic Cavity ◽  
Imaging Method ◽  
Visual Methods ◽  
Timely Diagnosis ◽  
Ultrasound Diagnostics ◽  
Choice Of Treatment

Diagnosis of endometrioid heterotopias of the pelvic cavity is often complicated, because at the initial stage there are no characteristic sonographic signs of this pathology. However, transvaginal ultrasound can be used as the main imaging method in the patients with suspected endometriosis. Due to a wide variety of forms and degrees of endometriosis, the similarity of clinical signs of other diseases, frequent asymptomatic course of the disease are objective difficulties in the correct and timely diagnosis of endometrioid heterotopias of the pelvic cavity. Ultrasonography can be used both to detect and to monitor the dynamics of endometriosis. Transvaginal sonography allows a qualitative detection of endometrioid heterotopias of the pelvis and with a high probability to reveal endometrioid cysts, hydrosalpinx, hematosalpinx, peritoneal endometriosis and is considered the best method of visualization of the endometrium. There were examined 57 patients with various forms of endometrioid heterotopias of the pelvic organs by transvaginal ultrasonography, which was performed on the 5th−9th day of the menstrual cycle. Adenomyosis of various degrees has been diagnosed, which should be understood as a disease consisting of ectopic location of endometrial glands and stroma as well as muscle changes. Due to the variety of forms and degrees of endometriosis, combination with clinical signs of other diseases, often asymptomatic course of the disease, which leads to severe damage to the reproductive system, there are objective difficulties in correct and timely diagnosis of endometrioid heterotopias and pelvic cavity organs. Modern visual methods of transvaginal ultrasonography are the key to correctly determining the stage and extent of endometriosis, which will directly affect the choice of treatment. Key words: endometriosis, heterotopia, ultrasound diagnostics, pelvic cavity.

scholarly journals Prevention of preterm delivery in women with multiple pregnancy

2018 ◽  
Vol 22 (1) ◽  
pp. 126-132
Author(s):  
A.V. Tkachenko
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Rating Scale ◽  
Transvaginal Ultrasound ◽  
Multiple Pregnancy ◽  
Clinical Signs ◽  
Cervical Canal ◽  
Cervical Insufficiency ◽  
Cervical Incompetence ◽  
Vaginal Pessary

The objective — to asses the effectiveness of obstetric pessary for cervical incompetence correction in women with multiple pregnancy and infertility in the anamnesis, treated by ART. 30 ART treated pregnant women with infertility in the anamnesis, with dichorionic diamniotic twins (DCDA) were divided into 3 groups, depending on the gestational age when cervical incompetence was diagnosed and vaginal pessary placed: the I group consisted of 5 pregnant women (17%), whom pessary was inserted at 19–22 gestational weeks, the II group included 18 (60.0%) women with correction of cervical insufficiency from 23 to 27 weeks of gestation, the III — 7 (23%) of the patients with pessary implementation in terms of 28–32 gestational weeks. Diagnosis of cervical incompetence was based on the FMF criterias, the Score Rating Scale (Shtember Scale in the modification of G.M. Savelieva) and cervical indices (CI). The sonographic evaluation of cervical insufficiency considered the cervical length (less than 25 mm), opening of the internal os and / or cervical canal (9 mm or more), ICSC>0.22, IPC>0.18 and the Rating Scale score > 5–6 points. With the aim to treat cervical incompetence during pregnancy, silicone vaginal pessary (ASQ, perforated) was used. The cervical assessment by transvaginal ultrasound probe was performed every 2 weeks and evaluated 1 month after correction. The data obtained were processed statistically, using the Microsoft Excel software. The average age of pregnant women was 27.7±2.8 years (28–38 years). Extragenital pathology was determined in 83.3% of women. All pregnant women had infertility in anamnesis, treated by ART, 18 (60%) by standard IVF procedure and 12 (40%) using ICSI method. The number of primiparous and multiparous women was the same. Within pregnancy duration, there were artificial abortions in 8 (53,3%), miscarriages in 7 (46,7%), prematurity in 3 (20,0%) and term delivery in 2 (13,3%) patients in the anamnesis. The current pregnancy was complicated by threatened abortions in all groups, which clinical signs most often occurred within 8–10 and 14–17 weeks of gestation. The average duration of pessary placement in groups was 15.0±1.8; 12.2±1.6 and 4.7±2.1 weeks, respectively. According to ultrasonography evaluation, the visual lengthening of the cervix from 21.6±3.4 mm to 30.2±3.6 mm (p<0,05) were observed in all groups, during the first week of treatment. Preterm delivery occurred in 6 (20%) women, among them before 32 weeks — 3.3%, 32–34 weeks — 10% and in 35–36 weeks — 6.5% of observations. 16.7% of pregnant women had vaginal delivery, 25 (83.3%) underwent Cesarean Section, 76.7% of them had a planned CS. No cases of antenatal or intranatal fetal death happened, as well as newborns with extremely low body weight were not observed in women of all three groups. Results were obtained testify the role of cervical incompetence in the pathogenesis of perinatal losses in women with multiple pregnancy. Evaluation and diagnosis of cervical insufficiency to predict and prevent premature labor in such group of patients should be based on criteria of Fetal Medicine Foundation (FMF), using the method of transvaginal ultrasound cervicometry. An additional calculation of cervical indices may improve the reliability of the prognostic technique. The safety, accessibility and efficacy of obstetric vaginal pessary usage for non-surgical correction of cervical incompetence, as well as absence of severe complications in women with twin pregnancies, have been demonstrated.

scholarly journals Efficiency Biliopancreatic bypass surgery in bulimia nervosa

2008 ◽  
Vol 5 (2) ◽  
pp. 27-31
Author(s):  
Yu I Yashkov ◽  
D K Bekuzarov ◽  
A V Nikol'skiy
Keyword(s):  
Morbid Obesity ◽  
Surgical Treatment ◽  
Bulimia Nervosa ◽  
Bypass Surgery ◽  
Clinical Signs ◽  
Small Sample ◽  
Choice Of Treatment ◽  
Treatment Of Obesity ◽  
Uncontrolled Eating

A clinical significance in the treatment of bulimia nervosa patients with morbid obesity had already been raised [10, 13], but we did not find publications on the effectiveness of bariatric surgery in these cases. There is also information about the possibility of applying the operation bilio-pancreatic bypass, effective in patients with morbid obesity with uncontrolled eating behavior for the treatment of patients with anorexia BILIM not suffering from morbid obesity. In this article the data of clinical observation of a small sample of patients. As a result, the treatment of these patients found that severe nervous BILIM can be seen as a latent form of morbid obesity. The choice of treatment should depend not only on the initial body weight of the patient, but also on the severity of the nervous BILIM. Unsuccessful attempts at organized-balanced, conservative treatment of patients with severe bulimia nervosa may be considered a variant of surgical treatment, while bilio-pancreatic bypass surgery is considered as the most preferred operation, compared with the installation of the gastric balloon and others. All candidates for surgical treatment of obesity must identify clinical signs of bulimia nervosa, as this may influence the choice of method of operation. Further study of the role of hyperinsulinemia, secretion of ghrelin, leptin, intestinal peptide may contribute to the elucidation of the true causes of bulimia nervosa, probably has a similar origin with morbid obesity.

scholarly journals MIGRATION OF THE INTRAUTERINE DEVICE TO THE ABDOMINAL CAVITY

2017 ◽  
Vol 25 (2) ◽  
pp. 247-262
Author(s):  
D. A. Rahmonov ◽  
F. Sh. Rashidov ◽  
E. L. Kalmykov ◽  
M. M. Marizoeva ◽  
O. B. Bobdjonova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Intrauterine Device ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Uterine Cavity ◽  
Pain Syndrome ◽  
Pregnant Patient ◽  
Pelvic Cavity ◽  
And Migration ◽  
Laparoscopic Removal

The aim: demonstration of our experience of surgical treatment of patients with migrated intrauterine device (IUD) into the abdominal cavity. The results of surgical treatment of migrated IUDs in the pelvic cavity are summarized in 17 women. The average age of the patients was 33,23,4 years. The timing of implantation of the IUDs varied from 10 days to 24 months. In all cases, the intra operational finding was T-shaped a copper device. The reason behind the women's consultation was an increase in pain syndrome in the lesser pelvis (n=15), dysuric phenomenon (n=1) and the onset of pregnancy (n=1). Perforation of the uterus and migration of the spiral occurred from 10 days to 2 years after its implantation. All patients were operated laparoscopicaly. The average duration of operations was 45,510,5 minutes. In the postoperative period there were no complications from the pelvic organs and postoperative wounds. The period of hospitalization of patients was 3,50,7 days. In all cases there was a regression of clinical signs and recovery. In one pregnant patient (gestation period 5-6 weeks) the pregnancy proceeded without particular pathological abnormalities and resulted in the birth of a full-term child. Laparoscopic removal of the IUD migrating from the uterine cavity to the abdominal cavity is the method of choice in the treatment of this group of patients, avoiding development of intra- and postoperative complications and a shorter length of stay in the hospital. The effectiveness of the procedure reaches 100%. The most common cause of complication of the IUD is the perforation of the uterus during its implantation.

scholarly journals Evaluation of pre induction scoring by clinical examination vs transvaginal sonography

2016 ◽  
Vol 6 (1) ◽  
pp. 228
Author(s):  
Sonali Kaur Sharma ◽  
Madhu Nagpal ◽  
CL Thukral
Keyword(s):  
Vaginal Delivery ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Transvaginal Sonography ◽  
Bishop Score ◽  
Unfavourable Cervix ◽  
Successful Induction ◽  
Singleton Pregnancies

Background: The aim of the study was to find out pre-induction cervical length by TV Sonography, determine Bishops score and to co-relate the obstetric outcome with these two variables.Methods: A study was done on 100 women with singleton pregnancies at 37-42 weeks of gestation, admitted for induction of labour in the Department of Obstetrics and Gynaecology at SGRDIMSR, Vallah, Amritsar, Punjab, India. All women underwent cervical assessment by both transvaginal ultrasound and Bishop Score and the outcome of labour induction was determined.Results: Of the 100 women, 53 women had vaginal delivery and 47 landed into LSCS. Bishop score < 6 and cervical length > 3 cm are cut off values of cervical unfavourablity. Successful induction was achieved among 87.5% and 78% women with favorable cervix according to Bishop Score and Cervical length respectively .Among the 92 and 50 women with unfavourable cervix according to Bishop score and cervical length, 48 (52.17%) and 14 (28%) had vaginal delivery respectively.Conclusions: Hence, cervical length by transvaginal ultrasound is a better predictor for the success of induction of labour as compared with assessment by Bishop Score alone.

scholarly journals Audit of transvaginal sonography of normal postmenopausal ovaries by sonographers from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1241
Author(s):  
Will Stott ◽  
Aleksandra Gentry-Maharaj ◽  
Andy Ryan ◽  
Nazar Amso ◽  
Mourad Seif ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
United Kingdom ◽  
Cancer Screening ◽  
Transvaginal Ultrasound ◽  
Probit Model ◽  
Transvaginal Sonography ◽  
Ovarian Cancer Screening ◽  
Subsequent Increase ◽  
Collaborative Trial ◽  
The United Kingdom

Background: We report on a unique audit of seven sonographers self-reporting high visualization rates of normal postmenopausal ovaries in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). This audit was ordered by the trial’s Ultrasound Management Subcommittee after an initiative taken in 2008 to improve the quality of scanning and the subsequent increase in the number of sonographers claiming very high ovary visualisation rates. Methods: Seven sonographers reporting high rates (>89%) of visualizing normal postmenopausal ovaries in examinations performed between 1st January and 31st December 2008 were identified. Eight experts in gynaecological scanning reviewed a random selection of exams performed by these sonographers and assessed whether visualization of both ovaries could be confirmed (cVR-Both) in the examinations. A random effects bivariate probit model was fitted to analyse the results.   Results: The eight experts reviewed images from 357 examinations performed on 349 postmenopausal women (mean age 60.0 years, range 50.2-73.3) by the seven sonographers. The mean cVR-Both obtained from the model for these sonographers was 67.2% with a range of 47.6-86.5% (95%CI 63.9-70.5%). The range of cVR-Both between the experts was 47.3-88.3% and the intra-class correlation coefficient (ICC) for left and right ovary confirmation was 0.39.    Conclusions: The audit suggests that self-reported visualization of postmenopausal ovaries is unreliable, as visualisation of both ovaries could not be confirmed in almost a third of examinations. The agreement for visualization of both ovaries based on review of a static image between experts and sonographers and between expert reviewers alone was only moderate. Further research is needed to develop reliable Quality Control metrics for transvaginal ultrasound.

scholarly journals Modern ultrasound technologies in monitoring the effectiveness of chemotherapy for cervical cancer

2019 ◽  
Vol 21 (3) ◽  
pp. 56-61
Author(s):  
Zalina R-B Musaeva ◽  
Marina A Chekalova ◽  
Andrei A Mesheryakov
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
New Technologies ◽  
Tumor Regression ◽  
Ultrasound Elastography ◽  
Cancer Drug ◽  
Imaging Method ◽  
Medical Problems ◽  
Ultrasound Diagnostics ◽  
Mortality Improvement

Cervical cancer remains one of the most important social and medical problems worldwide due to the increase in morbidity and mortality. Improvement of existing and development of new options for diagnosis and treatment of common stages of cervical cancer is an urgent problem of modern Oncology. In accordance with the standards of treatment for advanced cervical cancer, drug, radiation therapy and surgical treatment in various modifications are used. Neoadjuvant chemotherapy can reduce the volume of tumors, which helps to achieve optimal resectability of the tumors, increases the ablasticity of the operation. In addition, it improves survival. An accurate assessment of the effectiveness of treatment is one of the important factors in the overall treatment. Complex ultrasound diagnostics is the most affordable and common imaging method, possessing a number of important technologies, allowing you to get the most objectively visualized tumors, uterus, prevalence, blood flow features and to receive timely information about tumor regression. In connection with the introduction of new technologies, a significant expansion of the capabilities of ultrasound diagnostics in oncology as a whole is observed today. The most promising of them are ultrasound elastography and contrast-enhanced ultrasound. The review is devoted to the possibilities of these methods in assessing the effectiveness of neoadjuvant chemotherapy.

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 Magnetic Resonance Cholangiopancreatography Evaluation of Biliary Tract, Gall Bladder, and Pancreas

2021 ◽  
Vol 8 (12) ◽  
pp. 710-714
Author(s):  
Rama Krishna Narra ◽  
Sivaram Prasadbabu Badisa ◽  
Tejaswini Yatam ◽  
Bhimeswarao Pasupaleti
Keyword(s):  
Magnetic Resonance ◽  
Gall Bladder ◽  
Biliary Tract ◽  
Clinical Signs ◽  
Biliary Tract Disease ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical Suspicion ◽  
Imaging Method ◽  
Periampullary Carcinoma ◽  
Study Results

BACKGROUND Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive imaging method of demonstration of hepatic, cholangio- and pancreatic-systems and their duct system and depends on heavy T2-weighted (T2-W) images. The present study was undertaken to study and evaluate patients with clinical suspicion of the biliary tract, gall bladder and pancreatic pathology, with conventional magnetic resonance imaging (MRI) and MRCP and to assess the pitfalls in MRCP for the evaluation of the biliary tract, gall bladder, and pancreas. METHODS The study included sixty patients with clinical signs and symptoms of obstructive jaundice referred for MRCP to the Department of Radiodiagnosis at Katuri Medical College and Hospital and patients who were referred to the department with clinical suspicion of pancreas, gallbladder and biliary tract disease. Pregnant patients, claustrophobic patients and patients with MRI contraindications such as cardiac pacemakers, aneurysm clips and metallic implants were excluded from the study. RESULTS Most of the patients in our study were of 30 - 70 years age group. Of the sixty cases included in our study, 58 % were males and 42 % were females. In most of the patients, in our study, benign pathology was observed which included cholelithiasis and choledocholithiasis and acute pancreatitis being next common. Case of choledochal cyst were also encountered. Most of common bile duct strictures were of benign aetiology. Of the malignant pathology detected, cholangiocarcinoma followed by periampullary carcinoma and gallbladder carcinoma were commonly encountered. CONCLUSIONS Magnetic resonance pancreatic cholangiography is an imaging modality for evaluation of pancreaticobiliary disorders. MRCP detected the exact location and cause of biliary tract obstruction and aetiology was well demonstrated. Pure cholesterol stones are difficult to detect on CT because they are iso attenuating or slightly hypoattenuating to bile. Sub centimetric calculi are well demonstrated by MRCP. Malignant strictures and benign strictures are well demonstrated. MRCP being non-invasive and radiation hazard free with inherent high resolution with multiplanar imaging capability could be considered as gold standard in imaging of few gall bladder and biliary system disorders. KEYWORDS Magnetic Resonance Cholangiopancreatography, Cholelithiasis, Pancreatitis, Periampullary Carcinoma, Gall Bladder Carcinoma, Cholangiocarcinoma

Association Rate between Incisional and Pelvic Endometriosis

2011 ◽  
Vol 3 (4) ◽  
pp. 183-187 ◽  
Author(s):  
Saeed Alborzi ◽  
Bahareh Hamedi ◽  
Sedigheh Abbasi ◽  
Mohammad Ebrahim Parsanejad ◽  
Jaleh Zolghadri
Keyword(s):  
Abdominal Wall ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Pelvic Cavity ◽  
Pelvic Endometriosis ◽  
Association Rate ◽  
Abdominal Wall Endometriosis ◽  
The Mean ◽  
Clinical Signs And Symptoms ◽  
Wall Mass

Purpose To investigate the association rate between abdominal wall and pelvic endometriosis in a population of Iranian patients, in University and private hospitals of Shiraz University of Medical Sciences. Methods 30 women were diagnosed as abdominal wall endometriosis according to the clinical signs and symptoms (dysmenorrhea, dyspauronia and pelvic pain) and the sonographic findings. The mean age of the patients was 30.5 ±3.3 (range 21–35) years. All the patients underwent resection of abdominal wall mass and investigation of the pelvic cavity for detecting pelvic endometriosis by laparoscopy. The pelvic endometriosis was scored and the stage was determined. Results 28 (93.3%) patients were found to have concomitant pelvic endometriosis. The mean score of pelvic endometriosis was 9.3 ± 6.6 (range 3–33). Of the patients, 10 (33.3%) suffered from stage I endometriosis, 16 (53.3%) from stage II, and 2 (6.7%) from stage III. Only 2 (6.7%) patients did not have concomitant pelvic endometriosis. The abdominal wall mass was successfully excised in all the cases. The histopathology diagnosis was confirmed in all the cases. Conclusions The association rate between abdominal wall and pelvic endometriosis is higher than that previously reported, up to 90%. Thus, routine investigation of the pelvic cavity is recommended in all the patients with abdominal wall endometriosis.

Risk factors and treatment methods affecting quality of life in patients with benign prostatic hyperplasia and prostate cancer

2021 ◽  
pp. 46-58
Author(s):  
Maya Andreevna Kuzmina ◽  
Darya Dmitrievna Vasina ◽  
Mark Albertovich Volodin ◽  
Denis Igorevich Volodin ◽  
Evgeniy Nikolaevich Bolgov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Risk Factors ◽  
Benign Prostatic Hyperplasia ◽  
Clinical Signs ◽  
Underlying Disease ◽  
Modern Medicine ◽  
Prostatic Hyperplasia ◽  
Timely Diagnosis

One of the key concepts of modern medicine is the quality of life associated with health, which is influenced by the initial underlying disease, its timely diagnosis and quality treatment, as well as rehabilitation, further prevention and identification of complications that have arisen. The conditions and lifestyle of the patient play an important role, not only his physical health, but also mental health. Despite the fact that benign prostatic hyperplasia (BPH) is not a life-threatening disease, its main clinical signs are symptoms of dysfunction of the lower urinary tract, which to a greater extent cause discomfort to patients and significantly reduce their quality of life. One of the triggering factors for the development of prostate cancer is neglected cases of BPH progression. The occurrence of prostate cancer, as a consequence of BPH, undoubtedly worsens the patient's quality of life and requires timely diagnosis, detection and immediate treatment. Based on the literature data, the article analyzes the risk factors for the occurrence and the main methods of treatment for BPH and prostate cancer, which negatively affect the patient's quality of life.

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