The Role of 3.0T MRI in the Assessment of Deep Endometriosis Located on the Uterosacral Ligaments

2013 ◽  
Vol 5 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Lucia Manganaro ◽  
Valeria Vinci ◽  
Silvia Bernardo ◽  
Paola Storelli ◽  
Eliana Fuggetta ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Deep Infiltrating Endometriosis ◽  
Ovarian Endometriosis ◽  
Deep Endometriosis ◽  
Uterosacral Ligaments ◽  
3.0 T ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Purpose To assess the diagnostic accuracy of 3.0T magnetic resonance imaging (MRI) in assessing the involvement of uterosacral ligaments (USLs) in deep infiltrating endometriosis (DIE). Methods Between July 2010 and July 2012, 42 women, aged between 19 and 45 years (mean age 28 years), with a diagnosis of cystic ovarian endometriosis and scheduled for laparoscopic treatment, underwent pre-operative 3.0-T MRI examination. USL was considered normal when it was not visible or when it was thin and regular. Results We found USL involvement in 20/42 cases: 4/20 had bilateral involvement, 16/20 had monolateral involvement; in the right ligament in 9/16 cases and in the left in 7/16. Asymmetric morphology was found in 17 patients with an arciform shape associated with increased thickness of the ligament. A thickness >3 mm was considered positive. These patients also presented thickening of the torus uterinus region. In three cases complete cul de sac obliteration led to loss of tissue plane which hindered identification of the USLs. Comparison with laparoscopy findings enabled us to achieve the following statistical values: 94.7% sensitivity, 91.3% specificity, 90.0% positive predictive value, 95.4% negative predictive value, and 93% diagnostic accuracy. Conclusions Optimal visualization of USLs was obtained on para-axial scans on T2W and T1W sequences which allowed an optimal anatomic visualization. In our study we demonstrated that 3.0T imaging enabled an optimal assessment of USL involvement to select patients for the correct kind of surgery or follow-up of these patients.

Altered microstructure integrity of the amygdala in schizophrenia: a bimodal MRI and DWI study

2010 ◽  
Vol 41 (2) ◽  
pp. 301-311 ◽  
Author(s):  
B. Tomasino ◽  
M. Bellani ◽  
C. Perlini ◽  
G. Rambaldelli ◽  
R. Cerini ◽  
...  
Keyword(s):  
Emotional Processing ◽  
Structural Magnetic Resonance Imaging ◽  
Apparent Diffusion Coefficients ◽  
Tissue Organization ◽  
Water Diffusivity ◽  
Apparent Diffusion ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
And Diffusion

BackgroundThe amygdala plays a central role in the fronto-limbic network involved in the processing of emotions. Structural and functional abnormalities of the amygdala have recently been found in schizophrenia, although there are still contradictory results about its reduced or preserved volumes.MethodIn order to address these contradictory findings and to further elucidate the possibly underlying pathophysiological process of the amygdala, we employed structural magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI), exploring amygdalar volume and microstructural changes in 69 patients with schizophrenia and 72 matched healthy subjects, relating these indices to psychopathological measures.ResultsMeasuring water diffusivity, the apparent diffusion coefficients (ADCs) for the right amygdala were found to be significantly greater in patients with schizophrenia compared with healthy controls, with a trend for abnormally reduced volumes. Also, significant correlations between mood symptoms and amygdalar volumes were found in schizophrenia.ConclusionsWe therefore provide evidence that schizophrenia is associated with disrupted tissue organization of the right amygdala, despite partially preserved size, which may ultimately lead to abnormal emotional processing in schizophrenia. This result confirms the major role of the amygdala in the pathophysiology of schizophrenia and is discussed with respect to amygdalar structural and functional abnormalities found in patients suffering from this illness.

scholarly journals Rectovaginal Examination, Transvaginal Ultrasonography, and Magnetic Resonance Imaging as Diagnostic Tools for Identifying Deep Infiltrating Endometriosis Nodules

2018 ◽  
pp. 167
Author(s):  
Florencia Wirawan ◽  
Luky S Marwali ◽  
Refni Muslim ◽  
Eva R Silalahi ◽  
Harjo S Bayuaji ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Transvaginal Ultrasonography ◽  
Diagnostic Tools ◽  
Deep Infiltrating Endometriosis ◽  
Resonance Imaging ◽  
Rectosigmoid Colon ◽  
Uterosacral Ligaments ◽  
Infiltrating Endometriosis

    Objective: To investigate the comparison between rectovaginal examination (RVT), transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI) as diagnostic tools for identifying various Deep Infiltrating Endometriosis (DIE).   Methods: Prospective longitudinal study was done involving 31 women referred for surgical management of DIE. Calculation of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of RVT, TVUS and MRI for DIE were recorded.   Results: The mean age was 35.1 years. DIE were present in 95.45% of women which commonly located at uterosacral ligaments (58.33%), followed by rectovaginal (16,67%), rectosigmoid- colon (16.67%) and bladder-ureter (8.3%). TVUS had the best accuracy (RVT 50.24%; TVUS 88.85%; MRI 75.77%) among other diagnostic tools for nodules located at uterosacral ligaments (RVT 52.63%; TVUS 87%; MRI 40%) and rectovaginal (RVT 76.75%; TVUS 93.34%; MRI 80%), but it poorly identified nodules located at rectosigmoid (RVT 20%; TVUS 65.56%; MRI 88.75%) and bladder-ureteral area (RVT 50.44%; TVUS 87.66%; MRI 93.55%). RVT had good PPV (88.89%) but bad NPV (32.01%) profile, made it worth to be a screening diagnostic tool.   Conclusion: RVT was a good screening diagnostic tools as it could be done easily but was weak in diagnosing anterior DIE. TVUS gave a better diagnosis rates on DIE located at sacrouterina ligaments and rectovaginal area whereas MRI did better on bowel DIE (rectosigmoid- colon area) and urological DIE (bladder-ureteral area).    Keywords: deep infiltrating endometriosis, magnetic resonance imaging, tranvaginal ultrasonography

scholarly journals Full-Thickness Excision versus Shaving by Laparoscopy for Intestinal Deep Infiltrating Endometriosis: Rationale and Potential Treatment Options

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Antonio Simone Laganà ◽  
Salvatore Giovanni Vitale ◽  
Maria Antonietta Trovato ◽  
Vittorio Italo Palmara ◽  
Agnese Maria Chiara Rapisarda ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Laparoscopic Approach ◽  
Deep Infiltrating Endometriosis ◽  
Full Thickness ◽  
Intestinal Endometriosis ◽  
Deep Endometriosis ◽  
Uterosacral Ligaments ◽  
Intestinal Involvement ◽  
Full Thickness Excision ◽  
Infiltrating Endometriosis

Endometriosis is defined as the presence of endometrial mucosa (glands and stroma) abnormally implanted in locations other than the uterine cavity. Deep infiltrating endometriosis (DIE) is considered the most aggressive presentation of the disease, penetrating more than 5 mm in affected tissues, and it is reported in approximately 20% of all women with endometriosis. DIE can cause a complete distortion of the pelvic anatomy and it mainly involves uterosacral ligaments, bladder, rectovaginal septum, rectum, and rectosigmoid colon. This review describes the state of the art in laparoscopic approach for DIE with a special interest in intestinal involvement, according to recent literature findings. Our attention has been focused particularly on full-thickness excision versus shaving technique in deep endometriosis intestinal involvement. Particularly, the aim of this paper is clarifying from the clinical and methodological points of view the best surgical treatment of deep intestinal endometriosis, since there is no standard of care in the literature and in different surgical settings. Indeed, this review tries to suggest when it is advisable to manage the full-thickness excision or the shaving technique, also analyzing perioperative management, main complications, and surgical outcomes.

scholarly journals Predictive Value of Preoperative MRI Using the #ENZIAN Classification Score in Patients with Deep Infiltrating Endometriosis

2021 ◽  
Author(s):  
Aysun FENDAL TUNCA ◽  
Derya Ece Iliman ◽  
Aysegul Akdogan Gemici ◽  
Cihan Kaya
Keyword(s):  
Sensitivity And Specificity ◽  
Deep Infiltrating Endometriosis ◽  
Predictive Values ◽  
Classification Score ◽  
Uterosacral Ligaments ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity ◽  
Infiltrating Endometriosis ◽  
Higher Sensitivity

Abstract Purpose The aim of this study is to investigate the correlation between the magnetic resonance imaging (MRI) and intraoperative findings of deep infiltrating endometriosis using the #ENZIAN score. Methods This retrospective study included 64 patients who underwent surgery for deep infiltrating endometriosis between January 2017 and August 2020. Preoperative abdominopelvic MRI assessment was evaluated and scored using the #ENZIAN classification. Operative scores were considered the gold standard, and the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of MRI for each category were calculated. Results MRI has higher sensitivity and specificity in showing the lesions of the compartments O (ovarian lesions), A (rectovaginal septum and posterior vaginal fornix), and B (uterosacral ligaments and parametrium) (100–100%, 100–100%, and 97–100%, respectively, p<0.001) compared to the other compartments. The lowest sensitivity, specificity, accuracy, and PPV of the MRI was found in compartment P (14%, 76%, 70%, and 7%, respectively). Conclusion We demonstrated that the #ENZIAN classification in MRI reports has significant sensitivity and specificity in compartments A, B (uterosacral ligaments and parametrium), and O. Furthermore, the determination of peritoneal lesions via MRI is inadequate.

scholarly journals Diagnostic accuracy of MRI for detecting cervical invasion in patients with endometrial carcinoma: A meta-analysis

2020 ◽  
Author(s):  
Qiu Bi ◽  
Guoli Bi ◽  
Junna Wang ◽  
Jie Zhang ◽  
Hongliang Li ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Carcinoma ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Preoperative Assessment ◽  
High Specificity ◽  
Cochrane Library ◽  
Dce Mri ◽  
3.0 T ◽  
Magnetic Resonance Imaging Mri

Abstract Background: Clinical management and the prognosis of endometrial cancer is closely related to cervical invasion. The diagnostic performance of MRI for detecting cervical invasion has not been comprehensively assessed. We aim to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in the preoperative assessment of cervical invasion and to analyze the influence of different imaging protocols in patients with endometrial carcinoma.Methods: An extensive search of articles about MRI in assessing cervical invasion in patients with endometrial carcinoma was performed in PubMed, Embase, Web of Science, Cochrane Library, and Clinical Trials from January 2000 to July 2019. Two reviewers independently evaluated the methodological quality of each study by using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Diagnostic accuracy results and additional useful information were extracted. Pooled estimation data was obtained by statistical analysis. Results: A total of 42 eligible studies were included in the meta-analysis. Significant evidence of heterogeneity was found for detecting cervical invasion (I2 = 74.1%, P = 0.00 for sensitivity and I2 = 56.2%, P = 0.00 for specificity). And the pooled sensitivity and specificity of MRI were 0.58 and 0.95 respectively. The use of higher field strength (3.0 T) demonstrated higher pooled sensitivity (0.74). Using diffusion-weighted imaging (DWI) alone presented higher pooled sensitivity (0.86) than using other sequences. Studies that used dynamic contrast-enhanced MRI (DCE-MRI) alone showed higher sensitivity (0.80) and specificity (0.96) than that used T2-weighted image (T2WI) alone.Conclusions: MRI shows high specificity for detecting cervical infiltration in endometrial carcinoma. Using DWI or a 3.0-T device may improve the pooled sensitivity. The use of DCE-MRI demonstrate higher pooled sensitivity and specificity than T2WI.

scholarly journals Case Report: Incidentally diagnosed hemangioma of the right atrioventricular groove in an athlete

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1080
Author(s):  
Asma Achour ◽  
Mezri Maatouk ◽  
Ahmed Miladi ◽  
Marouane Mahjoub ◽  
Mabrouk Abdelali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Rare Case ◽  
Surgical Excision ◽  
Resonance Imaging ◽  
Atrioventricular Groove ◽  
Incidental Discovery ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

The purpose of this article is to illustrate a rare case of a pericardial hemangioma of the right atrioventricular groove of incidental discovery in a tennis player who presented with cough and dyspnea and was treated by surgical excision with a favorable outcome. We also report the role of cardiac magnetic resonance imaging (MRI) in the diagnosis and management of this pericardial tumor.

Diagnostic Accuracy of ACR/EULAR 2010 Criteria for Rheumatoid Arthritis in a 2-Year Cohort

2011 ◽  
Vol 38 (7) ◽  
pp. 1250-1257 ◽  
Author(s):  
SOPHIE VARACHE ◽  
DIVI CORNEC ◽  
JOHANNE MORVAN ◽  
VALÉRIE DEVAUCHELLE-PENSEC ◽  
JEAN-MARIE BERTHELOT ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Exclusion Criteria ◽  
Recent Onset ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Sensitivity Specificity ◽  
Tree Condition

Objective.To evaluate the diagnostic accuracy of the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) and 1987 ACR criteria for rheumatoid arthritis (RA), and the respective role of the algorithm and scoring of the ACR/EULAR.Methods.In total, 270 patients with recent-onset arthritis of < 1 year duration were included prospectively between 1995 and 1997 and followed for 2 years. RA was defined as the combination, at completion of followup, of RA diagnosed by an office-based rheumatologist and treatment with a disease-modifying antirheumatic drug or glucocorticoid. We compared the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the criteria sets in the overall population, in the subgroup meeting the tree condition for ACR/EULAR scoring, and in the overall population classified according the full tree.Results.At baseline, 111 of the 270 patients had better alternative diagnoses and 16 had erosions typical for RA; of the 143 remaining patients, 52 had more than 6 ACR/EULAR 2010 points (indicating definite RA) and 91 had fewer than 6 points. After 2 years, 11/16 patients with erosions and 40/52 with more than 6 points had RA. 100 of the 270 patients met the reference standard for RA. Sensitivity, specificity, PPV, and NPV of the ACR/EULAR (full tree) were 51/100 (51%), 153/170 (90%), 51/68 (75.4%), and 153/202 (75.7%), respectively. Diagnostic accuracies of the ACR/EULAR score and ACR 1987 criteria were not statistically different.Conclusion.Much of the improvement of the ACR/EULAR criteria was ascribable to the use of exclusion criteria in the algorithm.

Histological and MRI Study of the Development of the Human Indusium Griseum

2019 ◽  
Vol 29 (11) ◽  
pp. 4709-4724
Author(s):  
Mihaela Bobić Rasonja ◽  
Darko Orešković ◽  
Vinka Knezović ◽  
Ivana Pogledić ◽  
Daniela Pupačić ◽  
...  
Keyword(s):  
Adult Brain ◽  
Post Mortem ◽  
Cortical Organization ◽  
Differentiation Pattern ◽  
3.0 T ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Study ◽  
Human Brains ◽  
Weighted Sequences

Abstract To uncover the ontogenesis of the human indusium griseum (IG), 28 post-mortem fetal human brains, 12–40 postconceptional weeks (PCW) of age, and 4 adult brains were analyzed immunohistochemically and compared with post-mortem magnetic resonance imaging (MRI) of 28 fetal brains (14–41 PCW). The morphogenesis of the IG occurred between 12 and 15 PCW, transforming the bilateral IG primordia into a ribbon-like cortical lamina. The histogenetic transition of sub-laminated zones into the three-layered cortical organization occurred between 15 and 35 PCW, concomitantly with rapid cell differentiation that occurred from 18 to 28 PCW and the elaboration of neuronal connectivity during the entire second half of gestation. The increasing number of total cells and neurons in the IG at 25 and 35 PCW confirmed its continued differentiation throughout this period. High-field 3.0 T post-mortem MRI enabled visualization of the IG at the mid-fetal stage using T2-weighted sequences. In conclusion, the IG had a distinct histogenetic differentiation pattern than that of the neighboring intralimbic areas of the same ontogenetic origin, and did not show any signs of regression during the fetal period or postnatally, implying a functional role of the IG in the adult brain, which is yet to be disclosed.

scholarly journals The Role of Laparoscopic Ultrasonography in the Evaluation of Suspected Choledocholithiasis. A Single-Center Experience

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 246
Author(s):  
Kristaps Atstupens ◽  
Maksims Mukans ◽  
Haralds Plaudis ◽  
Guntars Pupelis
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Diagnostic Methods ◽  
Laparoscopic Ultrasonography ◽  
Biliary Stones ◽  
Single Center Experience

Background and objectives: Opinions differ regarding the optimal diagnostic methods for patients with suspected choledocholithiasis. The aim of this study was to assess the diagnostic accuracy of laparoscopic ultrasonography (LUS) and compare it to pre-operative magnetic resonance cholangio-pancreatography (MRCP); Materials and Methods: In all patients with suspected choledocholithiasis LUS was performed during laparoscopic cholecystectomy to evaluate biliary stones. According to availability, part of the patients had pre-operative MRCP. Data for diagnostic accuracy and main outcomes were collected prospectively and analyzed retrospectively; Results: Choledocholithiasis was detected in 178 of 297 patients by LUS (59.93%) and in 39 of 87 patients by MRCP (44.8%), p = 0.041. LUS yielded a sensitivity of 99.4%, a specificity of 94.3%, a positive predictive value of 96.1% and a negative predictive value of 99.1%. However, pre-operative MRCP had a sensitivity of 61.7%, a specificity of 92.3%, a positive predictive value of 94.9% and a negative predictive value of 51.1%. Moreover, of the 47 patients with no choledocholithiasis by MRCP, in 23 cases it was later detected by LUS (a false negative MRCP finding—38.3%), p < 0.001. Median duration of hospitalization was significantly shorter in patients evaluated without pre-operative MRCP—8 days (interquartile range – IQR 11–6) vs. 11 days (IQR 14–9), p = 0.001; Conclusions: LUS may reduce the role of pre-operative MRCP and can become a rational alternative to MRCP as a primary imaging technique for the detection of choledocholithiasis.

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