scholarly journals Diagnostic Accuracy of Preoperative Conventional MRI for Patients With Ectopic Pregnancy

2021 ◽  
Vol 105 (1-3) ◽  
pp. 449-454
Author(s):  
Toshimichi Onuma ◽  
Kimihisa Tajima ◽  
Kumiko Sato ◽  
Katsushige Hattori ◽  
Shin Fukuda ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Predictive Value ◽  
Correct Diagnosis ◽  
Tubal Pregnancy ◽  
Mri Findings ◽  
Tubal Ectopic Pregnancy ◽  
Conventional Mri ◽  
Mri Diagnosis ◽  
Preoperative Magnetic Resonance ◽  
Magnetic Resonance Imaging Mri

Objective To assess the utility of preoperative magnetic resonance imaging (MRI) in the diagnosis of tubal pregnancy. Summary of background data Most cases of ectopic pregnancy are tubal pregnancies. Preoperative accurate diagnosis including the location of the tubal pregnancy is important. Method We performed a retrospective single-center cohort study evaluating patients who underwent surgery for ectopic pregnancy from April 2004 to March 2016 and who underwent preoperative MRI. Sixty patients were enrolled in the study. Chorion confirmed at the tubal pregnancy site detected by MRI was defined as a correct diagnosis. Results Mean estimated gestational age at the time of MRI according to the last menstrual period was 7 weeks (median: 5 weeks; range: 3–10 weeks). Ectopic pregnancy was diagnosed by MRI in 57 cases, and all cases were either left or right tubal pregnancy. In 52 cases, the actual position matched the MRI findings. In 5 cases, the location of tubal ectopic pregnancy was different from that diagnosed by MRI, or no tubal pregnancy was observed intraoperatively. In 2 cases, no ectopic pregnancy site was observed on MRI, but tubal pregnancy was confirmed by surgery. In one case, an ectopic pregnancy site was not found, and the tube showed normal findings on MRI. The sensitivity of MRI diagnosis was 96.2%, specificity was 16.7%, positive predictive value was 91.1%, and negative predictive value was 33.3%. Conclusion In cases of ectopic pregnancy treated surgically, the sensitivity of MRI diagnosis, including identification of the location of ectopic pregnancy, is high.

scholarly journals MRI findings in ruptured ovarian ectopic pregnancy: an unexplored avenue

2021 ◽  
Vol 10 (11) ◽  
pp. 4323
Author(s):  
Annu Singhal ◽  
Vivek C. Kottiyath ◽  
Tej Prakash Gupta ◽  
Prachi Arora
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Mri Findings ◽  
Tubal Ectopic Pregnancy ◽  
Urinary Tract Calculi ◽  
Pouch Of Douglas ◽  
Magnetic Resonance Imaging Mri ◽  
Ovarian Abscess

Ovarian ectopic pregnancy (OEP) is a rare form of ectopic pregnancy (EP) and constitutes approximately 0.5-3% of all ectopic cases. Its presentation mimics the symptoms of tubal ectopic pregnancy, hemorrhagic ovarian cyst/follicle, tubo-ovarian abscess, urinary tract calculi, appendicitis or ovarian torsion. Occasionally determining the anatomic location of an extra-tubal ectopic pregnancy based on ultrasound imaging and presentation alone can be challenging, particularly when it is adherent to the fallopian tube. Although transvaginal ultrasound (TVS) is the primary modality used in the diagnosis, various forms of OEP and its complications may be incidentally detected and further evaluated on computed tomography (CT) or magnetic resonance imaging (MRI) when an alternative diagnosis is suspected. We reported a case of a second gravid para zero, 25 years old lady, who came with pain in the left lower abdomen. Her urine pregnancy test was positive. TVS showed empty uterine cavity, an extremely tender, heterogenous hyperechoic right adnexal mass, but no obvious gestation sac (GS). A large hematoma was detected adjacent to it in the pouch of Douglas (POD). Keeping a high suspicion of ectopic pregnancy, MRI was performed to evaluate the lesion better which revealed a natural, non-assisted, ruptured right ovarian ectopic pregnancy and was subsequently confirmed at laparotomy and proven on histopathology. Patient underwent left oophorectomy and discharged on 4th day with uneventful follow up. 

Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

2018 ◽  
Vol 1 ◽  
pp. 9
Author(s):  
Harshad Arvind Vanjare ◽  
Jyoti Panwar
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Cuff Tear ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

scholarly journals Rapidly progressive dementia due to neurosarcoidosis

2013 ◽  
Vol 7 (4) ◽  
pp. 428-434
Author(s):  
Gabriela Carneiro C. Fortes ◽  
Marcos Castello B. Oliveira ◽  
Laura Cardia G. Lopes ◽  
Camila S. Tomikawa ◽  
Leandro T. Lucato ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Oral Prednisone ◽  
Brain Biopsy ◽  
High Dose ◽  
Mri Findings ◽  
Progressive Dementia ◽  
Granulomatous Angiitis ◽  
Severe Impairment ◽  
Magnetic Resonance Imaging Mri ◽  
One Year

ABSTRACT Rapidly progressive dementia (RPD) is typically defined as a cognitive decline progressing to severe impairment in less than 1-2 years, typically within weeks or months. Accurate and prompt diagnosis is important because many conditions causing RPD are treatable. Neurosarcoidosis is often cited as an unusual reversible cause of RPD. Methods: We report two cases of neurosarcoidosis presenting as RPD. Results: Case 1: A 61-year-old woman developed a RPD associated with visual loss. In seven months she was dependent for self-care. Magnetic resonance imaging (MRI) revealed temporal and suprasellar brain lesions. Treatment with high-dose intravenous prednisolone was associated with partial improvement. Case 2: A 43-year-old woman who was being treated for diabetes insipidus developed a severe episodic amnesia one year after onset of cognitive symptoms. Previous MRI had shown a hypothalamic lesion and she had been treated with oral prednisone and cyclophosphamide. There was reduction of the MRI findings but no improvement in the cognitive deficits. Brain biopsy disclosed noncaseous granulomas and granulomatous angiitis; treatment was changed to high-dose intravenous methylprednisolone, with poor symptomatic response. Conclusion: The diagnosis of RPD due to neurosarcoidosis can be challenging when the disease is restricted to the nervous system. In these cases, clinical presentation of RPD associated with neuroendocrine and visual dysfunction, imaging findings showing hypothalamic lesions and, in some cases, brain biopsy, are the key to a correct diagnosis. It is possible that earlier diagnoses and treatment could have led to a better outcome in these patients.

scholarly journals Use of FloSeal Sealant in the Surgical Management of Tubal Ectopic Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Mara Clapp ◽  
Jaou-Chen Huang
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Thermal Injury ◽  
Tubal Pregnancy ◽  
Effective Alternative ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Tubal Patency ◽  
Ectopic Pregnancies

Background. Surgery is sometimes required for the management of tubal ectopic pregnancies. Historically, surgeons used electrosurgery to obtain hemostasis. Topical hemostatic sealants, such as FloSeal, may decrease the reliance on electrosurgery and reduce thermal injury to the tissue.Case. A 33-year-old G1 P0 received methotrexate for a right tubal pregnancy. The patient became symptomatic six days later and underwent a laparoscopic right salpingotomy. After multiple unsuccessful attempts to obtain hemostasis with electrocoagulation, FloSeal was used and hemostasis was obtained. Six weeks later, a hysterosalpingogram (HSG) confirmed tubal patency. The patient subsequently had an intrauterine pregnancy.Conclusion. FloSeal helped to achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. FloSeal is an effective alternative and adjunct to electrosurgery in the surgical management of tubal pregnancy.

Hourglass-Like Constriction of the Brachial Plexus in the Posterior Cord: A Case Report

Neurosurgery ◽  
2017 ◽  
Vol 82 (1) ◽  
pp. E1-E5 ◽  
Author(s):  
Yasunobu Nakagawa ◽  
Hitoshi Hirata
Keyword(s):  
Brachial Plexus ◽  
Treatment Options ◽  
Surgical Approaches ◽  
Mri Findings ◽  
Surgical Interventions ◽  
Residual Symptoms ◽  
Arm Pain ◽  
Preoperative Magnetic Resonance ◽  
Magnetic Resonance Imaging Mri ◽  
Short Tau Inversion Recovery

Abstract BACKGROUND AND IMPORTANCE Hourglass-like constrictions are fascicular conditions confirmed definitively by interfascicular neurolysis. Certain peripheral nerves have vulnerable areas such as around the elbow in the posterior interosseous nerve. We report the first hourglass-like constriction in the brachial plexus supplying the radial innervated forearm musculature. Preoperative magnetic resonance imaging (MRI) findings of the brachial plexus were consistent with neuralgic amyotrophy (NA). CLINICAL PRESENTATION A 9-yr-old boy experienced worsening left arm pain and difficulty in elevating the shoulder. Sequentially, severe palsy emerged when extending the wrist, thumb, and fingers. Based on the clinical picture, we diagnosed him with NA. The oblique coronal T2-weighted short-tau inversion recovery images showed mildly diffuse enlargement and hyperintensity of the brachial plexus. He showed few signs of improvement and interfascicular neurolysis was performed 11 mo after the onset. One of the fascicles in the posterior cord had developed an hourglass-like constriction. Electrical stimulation confirmed that the fascicle supplied forearm muscles. His wrist and finger extension had almost recovered at the 12-mo postoperative visit. CONCLUSION Hourglass-like constrictions can occur in the brachial plexus. Although surgical approaches for the constrictions are still controversial, several reports demonstrated their effectiveness. Meanwhile, concerning NA treatment, evidence on the surgical intervention is lacking. Brachial plexus MRI might help in discerning the lesion and planning treatment options including surgical interventions. Hourglass-like constrictions are a possible etiology for certain NA patients with residual symptoms or paresis.

scholarly journals Histopathological assessment of optic nerve invasion guided by radiological findings in enucleated globes with retinoblastoma.

2020 ◽  
Author(s):  
Mohammed Abusayf ◽  
Hind Manaa Alkatan ◽  
Sahar Elkhamary ◽  
Saleh Almesfer ◽  
Azza MY Maktabi
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Demographic Data ◽  
Mri Findings ◽  
Level Of Invasion ◽  
Nerve Invasion ◽  
Unilateral Involvement ◽  
Magnetic Resonance Imaging Mri

Abstract Background: Optic nerve (ON) invasion is an important high-risk feature, and an indicator for neoadjuvant chemotherapy and prognosis. We aim through this study to correlate the detected-ON invasion by Magnetic resonance imaging (MRI) with the corresponding confirmed histopathological level of invasion. Methods: A retrospective study of enucleated globes with the diagnosis of retinoblastoma received in the histopathology department(s) from January 2015 to December 2016 (2 years). Slides were reviewed for ON invasion assessment, charts were reviewed for basic demographic data. All patients underwent MRI under sedation upon diagnosis and MRI findings were collected for the above correlation. Results: A total of 38 patients were included: 21 males and 17 females. 29 (77.3%) had unilateral involvement, 7 (18.4%) had bilateral involvement and 2 cases had trilateral disease. The overall mean age at diagnosis was 22.63 ±15.15 months. Histopathological examination revealed ON invasion in 28 cases (74%) distributed as follows: prelaminar (31.6%), laminar (18.4%), and post-laminar (23.7%). MRI confirmed post-laminar ON invasion in 8 cases (true positive) but failed to detect this in 1 case. Additionally, MRI detected another 8 cases of ON invasion that were false positive on histopathology (accuracy: 63.3%; sensitivity: 88.9%; specificity: 72.4%; Positive predictive value (PPV): 50%; Negative predictive value (NPV): 95.5%). Conclusions: MRI is found to be less sensitive in evaluating prelaminar and laminar ON invasion (0.0 and 42.9%) compared to post-laminar invasion (88.9%). MRI has generally better specificity in detecting ON invasion irrespective of the invasion level. In our study, obtaining deeper and/or additional histologic sections from the other surface of the tissue block in cases where a post-laminar ON invasion by MRI is found but not confirmed histopathologically in routine sections is essential to avoid missing such an important high-risk feature.

scholarly journals Brainstem Encephalitis Caused by Listeria monocytogenes

Pathogens ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 715
Author(s):  
Pengxu Wei ◽  
Ruixue Bao ◽  
Yubo Fan
Keyword(s):  
Listeria Monocytogenes ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Good Health ◽  
Enteric Neurons ◽  
Brainstem Encephalitis ◽  
Mri Findings ◽  
Periodontal Tissues ◽  
Magnetic Resonance Imaging Mri

International outbreaks of listerial infections have become more frequent in recent years. Listeria monocytogenes, which usually contaminates food, can cause potentially fatal infections. Listerial cerebritis is a rare disease that is encountered mostly in immunocompromised or elderly patients. However, listerial brainstem encephalitis (mesenrhombencephalitis or rhombencephalitis) is found in persons who were formerly in good health, and recognizing this disease, particularly at its early stages, is challenging. Listerial brainstem encephalitis has high mortality, and serious sequelae are frequently reported in survivors. Early recognition and correct diagnosis, as well as the timely use of appropriate antibiotics, can reduce the severity of listerial infections. The trigeminal nerve is proposed as a pathway through which L. monocytogenes reaches the brainstem after entering damaged oropharyngeal mucosa or periodontal tissues. This review introduces the clinical manifestations, pathology, magnetic resonance imaging (MRI) findings, diagnosis, and treatment of listerial brainstem encephalitis. Moreover, it proposes that L. monocytogenes may also invade the brainstem along the vagus nerve after it infects enteric neurons in the walls of the gastrointestinal tract.

scholarly journals A Rare Case of Bilateral Tubal Ectopic Pregnancy Following Intracytoplasmic Sperm Injection-Embryo Transfer (ICSI-ET)

2020 ◽  
Vol 42 (03) ◽  
pp. 165-168
Author(s):  
Ferruh Acet ◽  
Ege Nazan Tavmergen Goker ◽  
Ismet Hortu ◽  
Gulnaz Sahin ◽  
Erol Tavmergen
Keyword(s):  
Ectopic Pregnancy ◽  
Embryo Transfer ◽  
Tubal Pregnancy ◽  
Serum Progesterone ◽  
Tubal Ectopic Pregnancy ◽  
Vitro Fertilization ◽  
Reproductive Techniques ◽  
History Of ◽  
Β Hcg

AbstractBilateral tubal ectopic pregnancy is a very rare form of ectopic pregnancy. The incidence is higher in women undergoing assisted reproductive techniques or ovulation induction. We report the case of bilateral tubal ectopic pregnancy. The patient was 30 years old and had a 3-year history of infertility; she was referred to the in-vitro fertilization (IVF) program because of tubal factor infertility. A pregnancy resulted from the transfer of two embryos during an artificial cycle. Despite the increase in β-hCG values during the follow-up, 22 days after the embryo transfer, the β-hCG levels were 2,408 U/L and the serum progesterone (P4) level was 10.53 ng/ml. After application with methotrexate, β-hCG levels did not decrease effectively. Moreover, the sonographic screening revealed a suspicious bilateral tubal focus for ectopic pregnancy. A mini-laparotomy was performed and a bilateral tubal pregnancy was found. In the case of unilateral tubal pregnancy after the transfer of two embryos, the situation of the other tube should be systematically checked and β-hCG levels should be monitored.

scholarly journals CASE OF POLYCARPOUS TUBAL ECTOPIC PREGNANCY

2018 ◽  
pp. 79-81
Author(s):  
O. S. Nesterenko
Keyword(s):  
Ectopic Pregnancy ◽  
Tubal Pregnancy ◽  
Left Ovary ◽  
Tubal Ectopic Pregnancy ◽  
Uterine Tube ◽  
Yellow Body ◽  
Decidual Reaction ◽  
The Right

The case of multiple ectopic tubal pregnancy is presented in the 5–6 weeks term. An expanded right uterine tube containing two embryos was found. The amniotic partition was not visualized. The uterus is located typically, increased to 7–8 weeks of gestation, due to decidual reaction. The right ovary was identified in a typical place, the yellow body in its projection was not visualized. The left ovary was determined behind the uterus, in its projection the reminding yellow body was defined.

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