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Zhang H, Li J, Sun W, Hu Y, Zhang G, Shen M, Shi X. Hyaluronic acid-modified magnetic iron oxide nanoparticles for MR imaging of surgically induced endometriosis model in rats. PLoS One 2014; 9:e94718. [PMID: 24722347 PMCID: PMC3983238 DOI: 10.1371/journal.pone.0094718] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/18/2014] [Indexed: 01/09/2023] Open
Abstract
Endometriosis is defined as the presence of endometrial tissue outside the uterine, which may affect nearly 60% of women in reproductive age. Deep infiltrating endometriosis (DIE) defined as an endometriotic lesion penetrating into the retroperitoneal space or the wall of the pelvic organs to a depth of at least 5 mm represents the most diagnostic challenge. Herein, we reported the use of hyaluronic acid (HA)-modified magnetic iron oxide nanoparticles (HA-Fe3O4 NPs) for magnetic resonance (MR) imaging of endometriotic lesions in the rodent model. Sixteen endometriotic lesions were surgically induced in eight rats by autologous transplantation. Four weeks after lesion induction, three rats were scanned via MR imaging after tail vein injection of the HA-Fe3O4 NPs. Accordingly, the remaining five mice were sacrificed in the corresponding time points. The ectopic uterine tissues (EUTs) were confirmed by histological analysis. Quantification of Fe in the EUT was also performed by inductively coupled plasma-optical emission spectroscopy. Our results showed that by using the HA-Fe3O4 NPs, the EUTs were able to be visualized via T2-weighted MR imaging at 2 hours post injection, corroborating the Prussian blue staining results. The developed HA-Fe3O4 NPs could be used as negative contrast agents for sensitively detecting endometriosis in a mouse model and may be applied for future hyperthermia treatment of endometriosis.
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Affiliation(s)
- He Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, PR China
| | - Jingchao Li
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, PR China
| | - Wenjie Sun
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, PR China
| | - Yong Hu
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, PR China
| | - Guofu Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, PR China
- * E-mail: (GZ); (MS); (XS)
| | - Mingwu Shen
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, PR China
- * E-mail: (GZ); (MS); (XS)
| | - Xiangyang Shi
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, PR China
- * E-mail: (GZ); (MS); (XS)
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Corwin MT, Gerscovich EO, Lamba R, Wilson M, McGahan JP. Differentiation of Ovarian Endometriomas from Hemorrhagic Cysts at MR Imaging: Utility of the T2 Dark Spot Sign. Radiology 2014; 271:126-32. [DOI: 10.1148/radiol.13131394] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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103
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Wang JH. Ureteral endometriosis. UROLOGICAL SCIENCE 2014. [DOI: 10.1016/j.urols.2013.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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104
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Gui B, Valentini AL, Ninivaggi V, Marino M, Iacobucci M, Bonomo L. Deep pelvic endometriosis: don’t forget round ligaments. Review of anatomy, clinical characteristics, and MR imaging features. ACTA ACUST UNITED AC 2014; 39:622-32. [DOI: 10.1007/s00261-014-0091-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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105
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Iosca S, Lumia D, Bracchi E, Duka E, De Bon M, Lekaj M, Uccella S, Ghezzi F, Fugazzola C. Multislice computed tomography with colon water distension (MSCT-c) in the study of intestinal and ureteral endometriosis. Clin Imaging 2013; 37:1061-8. [DOI: 10.1016/j.clinimag.2013.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 06/06/2013] [Accepted: 07/05/2013] [Indexed: 01/07/2023]
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106
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Kalkur S, Raza A, Richardson RE. Right upper quadrant pain? Think outside the liver: A case of diaphragmatic perihepatic endometriosis. J OBSTET GYNAECOL 2013; 33:743-4. [DOI: 10.3109/01443615.2013.813914] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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107
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Xie M, Zhang X, Zhan J, Ren Y, Wang W. Potential role of strain elastography for detection of the extent of large-scar endometriosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:1635-1642. [PMID: 23980226 DOI: 10.7863/ultra.32.9.1635] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the clinical value of strain elastography for detection of the lesion extent of large-scar endometriosis and compare it to conventional sonography and magnetic resonance imaging (MRI). METHODS Eight patients suspected of having large-scar endometriosis underwent transabdominal sonography, strain elastography, and MRI. The mass was located and assessed for its size, imaging appearance, and, especially, widest boundary and vertical extent. After wide surgical excision and pathologic diagnosis, lesions in the central area shown on conventional sonography and the extended area shown on strain elastography underwent immunohistochemical examination. RESULTS Nodules were always deep in the subcutaneous plane, in contact with the fascia or muscle. Horizontally, the mean lesion size shown on conventional sonography was mainly consistent with the size on MRI in all cases, but it was obviously smaller on sonography than on strain elastography in 7 cases. Vertically, the lesion depth was mainly consistent with the depth on MRI in 7 cases, but it was more infiltrative on strain elastography in 6 cases. The vertical and horizontal infiltration scales of the postoperative specimens were consistent with strain elastography in all cases. All 8 patients showed strong collagen type I expression in the central area of the lesions; 6 patients showed strong collagen type I expression and the other 2 showed moderate expression in the extended area. CONCLUSIONS Strain elastography can elevate the diagnostic accuracy of large-scar endometriosis, the extent of which may be evaluated insufficiently by transabdominal sonography and MRI.
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Affiliation(s)
- Meng Xie
- Department of Ultrasound, Obstetrics and Gynecology Hospital, Fudan University, 128 Shen Yang Rd, 200090 Shanghai, China
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108
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Bedaiwy MA, Henry DN, Elguero S, Pickett S, Greenfield M. Accessory and cavitated uterine mass with functional endometrium in an adolescent: diagnosis and laparoscopic excision technique. J Pediatr Adolesc Gynecol 2013; 26:e89-91. [PMID: 23602039 DOI: 10.1016/j.jpag.2012.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 11/09/2012] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE Accessory and cavitated uterine masses (ACUM) with functional endometrium can be treated successfully with laparoscopic excision. The objectives of this report are to illustrate the surgical technique used for the removal of this uterine wall mass and to discuss the patient's clinical course and outcomes. DESIGN Surgical technique and description of 1 case. SETTING Department of Obstetrics and Gynecology, University Hospitals Case Medical Center. PARTICIPANT(S) A 16-year-old adolescent presented with severe dysmenorrhea and pelvic pain. Ultrasonographic examination and MRI demonstrated a cystic uterine wall mass distinct from the endometrial cavity. INTERVENTION(S) Laparoscopic excision of uterine mass. RESULTS Pathologic examination of the mass was consistent with an accessory and cavitated uterine mass. A 9-month follow-up after surgical excision of the mass confirmed complete symptom resolution. CONCLUSIONS ACUM is a unique and not uncommon pathologic category in the adolescent and young adult population. It is associated with severe and intractable dysmenorrhea and pelvic pain. Laparoscopic excision of these masses is justifiable, safe and feasible.
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Affiliation(s)
- Mohamed A Bedaiwy
- Department of Obstetrics and Gynecology, University Hospitals, Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
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Stabile Ianora AA, Moschetta M, Lorusso F, Lattarulo S, Telegrafo M, Rella L, Scardapane A. Rectosigmoid endometriosis: comparison between CT water enema and video laparoscopy. Clin Radiol 2013; 68:895-901. [PMID: 23809266 DOI: 10.1016/j.crad.2013.02.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 02/11/2013] [Accepted: 02/27/2013] [Indexed: 12/14/2022]
Abstract
AIM To evaluate the accuracy of water enema computed tomography (CT) for predicting the location of endometriosis in patients with contraindications to magnetic resonance imaging (MRI), focusing on rectosigmoid lesions and having laparoscopic and histological data as the reference standard. MATERIALS AND METHODS Thirty-three women (mean age 33.4 ± 3.1 years) suspected of having deep pelvic endometriosis underwent 64-row CT and video laparoscopy within 4 weeks. Two radiologists blinded to the clinical data evaluated the CT images obtained after colonic retrograde distension using water as the contrast medium, and a comparison with laparoscopic and histological findings was performed. CT sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated. The radiation dose to patients was estimated. Cohen's weighted kappa (κ) test was used to evaluate the interobserver agreement. RESULTS In 23 out of 33 patients (69%) intestinal implants were found at surgery and pathological examinations. CT confirmed the diagnosis of rectosigmoid endometriosis in 20 out of 23 implants. Three nodules located on the proximal sigmoid colon (two serosal lesions and one infiltrating the muscularis layer) with a diameter of less than 1 cm were not diagnosed. CT sensitivity, specificity, PPV, NPV, and accuracy values were 87, 100, 100, 77, and 91%, respectively. The mean effective dose estimate was 6.30 ± 1.7 mSv. Almost perfect agreement between the two readers was found (k = 0.84). CONCLUSION Water enema CT can play a role in the diagnosis of bowel endometriosis and represents another accurate potential tool for video laparoscopic approaches, especially in patients for whom MRI is contraindicated.
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Affiliation(s)
- A A Stabile Ianora
- Interdisciplinary Department of Medicine, Section of Radiology, University of Bari Medical School, Italy.
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110
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Hudelist G, Fritzer N, Staettner S, Tammaa A, Tinelli A, Sparic R, Keckstein J. Uterine sliding sign: a simple sonographic predictor for presence of deep infiltrating endometriosis of the rectum. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2013; 41:692-695. [PMID: 23400893 DOI: 10.1002/uog.12431] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/27/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate whether the presence of uterorectal adhesions demonstrated by transvaginal sonography (TVS) could aid as a simple sonographic predictor for deep infiltrating endometriosis (DIE) of the rectum in patients with symptoms suggestive of endometriosis. METHODS This was a prospective multicenter study of women scheduled for laparoscopy because of symptoms suggestive of endometriosis. Patients were assessed prospectively using TVS before laparoscopy and radical resection of disease followed by histological confirmation. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, accuracy and positive (LR+) and negative (LR-) likelihood ratios were calculated for the observation of a negative uterine 'sliding sign' on TVS in predicting the presence of DIE of the rectum. RESULTS In total, 117 patients underwent laparoscopy and resection. Thirty-four (29%) patients had DIE of the rectum. A negative sliding sign on TVS predicted DIE of rectum with a sensitivity of 85%, specificity of 96%, PPV of 91%, NPV of 94%, accuracy of 93.1%, LR + of 23.6 and LR- of 0.15. CONCLUSIONS Sonographic demonstration of uterorectal adhesions reflected by a negative uterine sliding sign is an easy and practical method for prediction of the presence of DIE involving the rectum. This could be a valuable 'red flag' sign for triaging patients to tertiary referral centers and specialized clinics for detailed investigation.
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Affiliation(s)
- G Hudelist
- Department of Obstetrics and Gynaecology/Stage III Center for Endometriosis & Pelvic Pain, Wilhelminen Hospital, Vienna, Austria.
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Uzunçakmak C, Güldaş A, Özçam H, Dinç K. Scar endometriosis: a case report of this uncommon entity and review of the literature. Case Rep Obstet Gynecol 2013; 2013:386783. [PMID: 23762683 PMCID: PMC3665185 DOI: 10.1155/2013/386783] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 04/17/2013] [Indexed: 11/17/2022] Open
Abstract
Scar endometriosis is an infrequent type of extrapelvic endometriosis that is rather close together with obstetrical and gynecological surgeries. It is mostly confused with other dermatological or surgical conditions and delays the diagnosis. We report a case of a 50-year-old woman presenting with scar endometriosis 23 years after her last lower segment caesarean section. The epidemiology, diagnosis, pathogenesis, and treatment of the situation are discussed.
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Affiliation(s)
- Cihangir Uzunçakmak
- Department of Obstetrics and Gynecology, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey
| | - Ahmet Güldaş
- Department of Obstetrics and Gynecology, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey
| | - Hasene Özçam
- Department of Obstetrics and Gynecology, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey
| | - Kemal Dinç
- Department of Obstetrics and Gynecology, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey
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Streuli I, de Ziegler D, Santulli P, Marcellin L, Borghese B, Batteux F, Chapron C. An update on the pharmacological management of endometriosis. Expert Opin Pharmacother 2013; 14:291-305. [PMID: 23356536 DOI: 10.1517/14656566.2013.767334] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Endometriosis is a common disease that causes pain symptoms and/or infertility in women in their reproductive years. The disease is characterised by the presence of endometrium-like tissue - glands and stroma - outside the uterine cavity. Different treatment options exist for endometriosis including medical and surgical treatments or a combination of the two approaches. The most commonly used medications are non-steroidal anti-inflammatory drugs, GnRH agonists, androgen derivatives such as danazol, combined oral contraceptive pills, progestogens and more recently the levonorgestrel intrauterine system. AREAS COVERED The authors review current medical treatments used for symptomatic endometriosis and also discuss new treatment approaches. The authors conducted a literature search for randomised controlled trials related to medical treatments of endometriosis in humans, searched the Cochrane library for reviews and also searched for registered trials that have not yet been published on ClinicalTrials.gov. EXPERT OPINION The medical treatment of endometriosis is effective at treating pain and preventing recurrence of disease after surgery. Remarkably, the oral contraceptive pill taken continuously is as effective as GnRH-a, while causing far less side-effects. Conversely, no treatment currently exists for enhancing fecundity in women whose infertility is associated with endometriosis. As all existing therapies of endometriosis are contraceptive, great efforts should be targeted at researching novel products that reduce the disease expression without shuttering ovulation.
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Affiliation(s)
- Isabelle Streuli
- Service de gynécologie, obstétrique et médecine de la reproduction, Groupe hospitalier du centre Cochin -- Broca -- Hôtel-Dieu, CHU Cochin, Paris, France
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Maccagnano C, Pellucchi F, Rocchini L, Ghezzi M, Scattoni V, Montorsi F, Rigatti P, Colombo R. Ureteral Endometriosis: Proposal for a Diagnostic and Therapeutic Algorithm with a Review of the Literature. Urol Int 2013; 91:1-9. [DOI: 10.1159/000345140] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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114
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The Value of Pelvic MRI in the Diagnosis of Posterior Cul-De-Sac Obliteration in Cases of Deep Pelvic Endometriosis. AJR Am J Roentgenol 2012; 199:1410-5. [DOI: 10.2214/ajr.11.7898] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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115
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Zhang H, Zhang GF, He ZY, Li ZY, Zhu M, Zhang GX. Evaluation of primary adnexal masses by 3T MRI: categorization with conventional MR imaging and diffusion-weighted imaging. J Ovarian Res 2012; 5:33. [PMID: 23148860 PMCID: PMC3576319 DOI: 10.1186/1757-2215-5-33] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 10/29/2012] [Indexed: 12/15/2022] Open
Abstract
Background To investigate the 3.0-Tesla (3 T) magnetic resonance imaging (MRI) characteristics of primary adnexal lesions for discriminating benign from malignant lesions. Methods One hundred thirty-nine patients with pathologically proven primary adnexal masses referred for 3 T MRI assessment preoperatively were included. Baseline characteristics, components, and conventional MRI and diffusion-weighted imaging (DWI-MRI) signals were recorded and compared. Results There were 22 ovarian cysts, 33 endometriomas, 43 benign tumors and 42 malignant tumors. When ovarian cyst and endometrioma were excluded, there were no significant differences in patients’ age between benign and malignant tumor (P = 0.235). There were no significant differences (P = 0.606) in the conventional MRI signals and significant difference (P = 0.008) in DWI-MRI signal between the non-malignant and malignant lesions. There was a significant difference (P = 0.000) in the apparent diffusion coefficient values (ADCs) between the non-malignant and malignant lesions. Conclusions 3 T MRI categorized the characteristics of primary adnexal lesions. Conventional MRI signals were not useful for characterizing between benign and malignant lesions. DWI-MRI and ADCs were helpful for distinguishing malignant from benign ovarian lesions.
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Affiliation(s)
- He Zhang
- Department of Radiology, Shanghai First People's Hospital, Medical College, Shanghai Jiaotong University, No, 100, Hai Ning Road, Shanghai, 200080, China.
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Gidwaney R, Badler RL, Yam BL, Hines JJ, Alexeeva V, Donovan V, Katz DS. Endometriosis of Abdominal and Pelvic Wall Scars: Multimodality Imaging Findings, Pathologic Correlation, and Radiologic Mimics. Radiographics 2012; 32:2031-43. [DOI: 10.1148/rg.327125024] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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117
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Herráiz Hidalgo L, Cano Alonso R, Carrascoso Arranz J, Alvarez Moreno E, Martínez de Vega Fernández V. [3.0T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part 2: Anorectal inflammatory disease. Postsurgical anatomy and complications after treatment]. RADIOLOGIA 2012; 56:206-18. [PMID: 23102780 DOI: 10.1016/j.rx.2012.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 06/27/2012] [Accepted: 07/05/2012] [Indexed: 01/06/2023]
Abstract
Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. In this second part of this image-based review of benign anorectal disease, we describe the most common inflammatory and fistulous diseases, the postsurgical anatomy, and complications that can occur after surgical treatment or radiotherapy for anorectal disease.
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Affiliation(s)
- L Herráiz Hidalgo
- Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España.
| | - R Cano Alonso
- Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España
| | - J Carrascoso Arranz
- Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España
| | - E Alvarez Moreno
- Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España
| | - V Martínez de Vega Fernández
- Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España
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Domínguez-Páez M, de Miguel-Pueyo LS, Medina-Imbroda JM, González-García L, Moreno-Ramírez V, Martín-Gallego A, Socolovsky M, Arráez-Sánchez MÁ. Ciatalgia secundaria a endometriosis extrapélvica del músculo piriforme. A propósito de un caso. Neurocirugia (Astur) 2012; 23:170-4. [DOI: 10.1016/j.neucir.2012.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 04/21/2012] [Accepted: 04/26/2012] [Indexed: 11/26/2022]
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119
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McDermott S, Oei TN, Iyer VR, Lee SI. MR Imaging of Malignancies Arising in Endometriomas and Extraovarian Endometriosis. Radiographics 2012; 32:845-63. [DOI: 10.1148/rg.323115736] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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120
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Francica G. Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar. World J Radiol 2012; 4:135-40. [PMID: 22590667 PMCID: PMC3351681 DOI: 10.4329/wjr.v4.i4.135] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 03/23/2012] [Accepted: 03/30/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To highlight sonographic and clinical characteristics of scar endometrioma with special emphasis on size-related features.
METHODS: Thirty women (mean age 30.6 years, range 20-42 years) with 33 scar endometriomas (mean diameter 27.1 mm, range 7-60 mm) were consecutively studied by Sonography and Color Doppler examination prior to surgery. Pathological examination was available in all cases.
RESULTS: The most frequent (24 of 33 nodules, 74%) sonographic B-mode aspect of endometrioma was that of an inhomogenously hypoechoic roundish nodule with fibrotic changes (in the form of hyperechoic spots or strands), a peripheral inflammatory hyperechoic ring, spiculated margins and a single vascular pedicle entering the mass at the periphery. On average, 1.6 cesarean sections were recorded per patient (range 1-3). The median interval between the last cesarean section and admission to hospital was 36 mo (range 12-120 mo) and the median duration of symptoms before admission was 25.7 mo (range 0.5-80 mo). 13 patients had 13 large endometriomas (≥ 30 mm) with a mean lesion diameter of 41.3 ± 9.02 mm (range 30-60 mm). Seventeen women had 20 small endometriomas with a mean lesion size of 18.2 ± 5.17 mm (range 7-26 mm). The mean interval between the last cesarean section and admission to hospital (66.0 mo vs 39.6 mo, P < 0.01) and the mean duration of symptoms before admission (43.0 mo vs 17.4 mo, P < 0.01) were significantly longer in patients with large endometriomas; in addition, a statistically significant higher percentage of patients with large implants had undergone previous inconclusive diagnostic examinations, including either computed tomography/magnetic resonance imaging/fine needle biopsy/laparoscopy (38.4% vs 0%, P < 0.05). On sonography, large endometriomas showed frequent cystic portions and fistulous tracts (P < 0.02), loss of round/oval shape (P < 0.04) along with increased vascularity (P < 0.04).
CONCLUSION: Endometrioma near cesarean section scar is an often neglected disease, but knowledge of its clinical and sonographic findings may prevent a delay in diagnosis that typically occurs in patients with larger (≥ 3 cm) endometriomas.
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Giusti S, Forasassi F, Bastiani L, Cela V, Pluchino N, Ferrari V, Fruzzetti E, Caramella D, Bartolozzi C. Anatomical localization of deep infiltrating endometriosis: 3D MRI reconstructions. ACTA ACUST UNITED AC 2012; 37:1110-21. [DOI: 10.1007/s00261-012-9848-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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122
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Benign and Suspicious Ovarian Masses-MR Imaging Criteria for Characterization: Pictorial Review. JOURNAL OF ONCOLOGY 2012; 2012:481806. [PMID: 22536238 PMCID: PMC3321462 DOI: 10.1155/2012/481806] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 01/15/2012] [Indexed: 01/13/2023]
Abstract
Ovarian masses present a special diagnostic challenge when imaging findings cannot be categorized into benign or malignant pathology. Ultrasonography (US), Computed Tomography (CT), and Magnetic Resonance Imaging (MRI) are currently used to evaluate ovarian tumors. US is the first-line imaging investigation for suspected adnexal masses. Color Doppler US helps the diagnosis identifying vascularized components within the mass. CT is commonly performed in preoperative evaluation of a suspected ovarian malignancy, but it exposes patients to radiation. When US findings are nondiagnostic or equivocal, MRI can be a valuable problem solving tool, useful to give also surgical planning information. MRI is well known to provide accurate information about hemorrhage, fat, and collagen. It is able to identify different types of tissue contained in pelvic masses, distinguishing benign from malignant ovarian tumors. The knowledge of clinical syndromes and MRI features of these conditions is crucial in establishing an accurate diagnosis and determining appropriate treatment. The purpose of this paper is to illustrate MRI findings in neoplastic and non-neoplastic ovarian masses, which were assessed into three groups: cystic, solid, and solid/cystic lesions. MRI criteria for the correct diagnosis and characteristics for differentiating benign from malignant conditions are shown in this paper.
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Clinical Management of Ovarian Endometriotic Cyst (Chocolate Cyst): Diagnosis, Medical Treatment, and Minimally Invasive Surgery. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2012. [DOI: 10.1007/s13669-011-0002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Magnetic resonance imaging in women with pelvic pain from gynaecological causes: a pictorial review. Radiol Med 2012; 117:575-92. [DOI: 10.1007/s11547-011-0773-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 06/21/2011] [Indexed: 11/30/2022]
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125
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HORI M, KIM T, ONISHI H, NAKAMOTO A, TSUBOYAMA T, TATSUMI M, TOMIYAMA N. Ovarian Masses: MR Imaging with T1-weighted 3-dimensional Gradient-echo IDEAL Water-fat Separation Sequence at 3T. Magn Reson Med Sci 2012; 11:117-27. [DOI: 10.2463/mrms.11.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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126
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Wu CJ, Huang KH, Kung FT. Deep infiltrating endometriosis with obstructive uropathy secondary to ureteral endometriosis. Eur J Obstet Gynecol Reprod Biol 2011; 160:239-40. [PMID: 22137572 DOI: 10.1016/j.ejogrb.2011.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 10/05/2011] [Accepted: 11/08/2011] [Indexed: 11/18/2022]
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127
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Adenomyosis: from the sign to the diagnosis. Imaging, diagnostic pitfalls and differential diagnosis: a pictorial review. Radiol Med 2011; 116:1267-87. [PMID: 21892720 DOI: 10.1007/s11547-011-0714-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Accepted: 01/17/2011] [Indexed: 10/17/2022]
Abstract
Adenomyosis is a pathological gynaecological condition characterised by benign invasion of the endometrium into the myometrium. It is often misdiagnosed, or is not easily recognised, although it is responsible for disabling symptoms such as menorrhagia, abnormal uterine bleeding, dysmenorrhoea and infertility in premenopausal women. The aim of this pictorial review is to analyse the features of adenomyosis by illustrating the most usual and typical imaging patterns, along with the unusual appearances, seen in a vast array of gynaecological imaging modalities. The different findings of focal and diffuse adenomyosis along with the diagnostic limitations of ultrasound, hysterosalpingography and magnetic resonance imaging are described, as are the pitfalls and differential diagnosis with other pathological conditions that are often misdiagnosed as adenomyosis. The role of the different imaging modalities in planning appropriate treatment and their usefulness in monitoring therapy are also discussed.
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128
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Hafidi R, Kouach J, Yakka M, Salek G, Oukabli M, Moussaoui RD, Dehayni M. L’endométriose cicatricielle de la paroi abdominale. IMAGERIE DE LA FEMME 2011. [DOI: 10.1016/j.femme.2011.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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129
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Caselli G, Besa C, Pulgar D. Intestinal obstruction as manifestation of a multifocal colonic endometriosis. Clin Gastroenterol Hepatol 2011; 9:e90-1. [PMID: 21683163 DOI: 10.1016/j.cgh.2011.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2011] [Revised: 04/15/2011] [Accepted: 04/24/2011] [Indexed: 02/07/2023]
Affiliation(s)
- Gino Caselli
- Unit of Colorectal Surgery, Department of Digestive Surgery, Pontifical Catholic University of Chile, Santiago, Chile
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130
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Endometriosis in the deltoid muscle: a case report. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2011. [DOI: 10.1007/s00590-011-0851-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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131
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Vassilieff M, Suaud O, Collet-Savoye C, Da Costa C, Marouteau-Pasquier N, Belhiba H, Tuech JJ, Marpeau L, Roman H. Coloscanner à l’air avec coloscopie virtuelle : arguments dans le choix du traitement chirurgical des endométrioses colorectales. ACTA ACUST UNITED AC 2011; 39:339-45. [DOI: 10.1016/j.gyobfe.2011.04.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Indexed: 01/07/2023]
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132
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Coccia ME, Rizzello F. Ultrasonographic staging: a new staging system for deep endometriosis. Ann N Y Acad Sci 2011; 1221:61-9. [DOI: 10.1111/j.1749-6632.2011.05951.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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133
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Hudelist G, English J, Thomas AE, Tinelli A, Singer CF, Keckstein J. Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: systematic review and meta-analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 37:257-263. [PMID: 20954166 DOI: 10.1002/uog.8858] [Citation(s) in RCA: 180] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To critically analyze the diagnostic value of transvaginal sonography (TVS) for non-invasive, presurgical detection of bowel endometriosis. METHODS MEDLINE (1966-2010) and EMBASE (1980-2010) databases were searched for relevant studies investigating the diagnostic accuracy of TVS for diagnosing deep infiltrating endometriosis involving the bowel. Diagnosis was established by laparoscopy and/or histopathological analysis. Likelihood ratios (LRs) were recalculated in addition to traditional measures of effectiveness. RESULTS Out of 188 papers, a total of 10 studies fulfilled predefined inclusion criteria involving 1106 patients with suspected endometriosis. The prevalence of bowel endometriosis varied from 24 to 73.3%. LR+ ranged from 4.8 to 48.56 and LR- ranged from 0.02 to 0.36, with wide confidence intervals. Pooled estimates of sensitivities and specificities were 91 and 98%; LR+ and LR- were 30.36 and 0.09; and positive and negative predictive values were 98 and 95%, respectively. Three of the studies used bowel preparations to enhance the visibility of the rectal wall; one study directly compared the use of water contrast vs. no prior bowel enema, for which the LR- was 0.04 and 0.47, respectively. CONCLUSIONS TVS with or without the use of prior bowel preparation is an accurate test for non-invasive, presurgical detection of deep infiltrating endometriosis of the rectosigmoid.
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Affiliation(s)
- G Hudelist
- Department of Obstetrics and Gynaecology, Endometriosis and Pelvic Pain Clinic, Wilhelminen Hospital, Vienna, Austria.
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134
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Floyd JR, Keeler ER, Euscher ED, McCutcheon IE. Cyclic sciatica from extrapelvic endometriosis affecting the sciatic nerve. J Neurosurg Spine 2011; 14:281-9. [DOI: 10.3171/2010.10.spine09162] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Sciatic (catamenial) radiculopathy, waxing and waning with the menstrual cycle, is an uncommon condition typically caused by pelvic endometriosis affecting the lumbosacral plexus or proximal sciatic nerve. The authors describe a woman with catamenial sciatica caused by endometriosis affecting the sciatic nerve trunk in the upper thigh. Symptomatic with leg pain for 5 years, this patient developed gluteal atrophy and sensory loss and decreased strength in the L-5 dermatomyotome, a distribution confirmed by electromyography. Magnetic resonance imaging suggested thickening of the sciatic nerve at and distal to the sciatic notch. At operation the nerve showed extrinsic and intrinsic abnormality, proven to be endometriosis. Her symptoms improved, and she began gonadotropin-releasing hormone agonist therapy for further suppression. This very unusual case shows that endometriosis can affect the sciatic nerve over a range of territory inside and outside the pelvis, and that surgery must be appropriately directed to avoid negative exploration. Surgical decompression achieves good relief of symptoms, and medical therapy also allows sustained suppression of this disease.
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Affiliation(s)
| | | | - Elizabeth D. Euscher
- 3Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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135
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Lee YR. CT imaging findings of ruptured ovarian endometriotic cysts: emphasis on the differential diagnosis with ruptured ovarian functional cysts. Korean J Radiol 2011; 12:59-65. [PMID: 21228941 PMCID: PMC3017885 DOI: 10.3348/kjr.2011.12.1.59] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 08/09/2010] [Indexed: 11/25/2022] Open
Abstract
Objective The purpose of this study is to assess the prevalence of abnormal CT findings in patients with surgically proven ruptured endometriotic cysts, as compared with those abnormal CT findings of ruptured ovarian functional cysts. Materials and Methods This study included 13 retrospectively identified patients with surgically confirmed ruptured ovarian endometriotic cysts and who had also undergone preoperative CT scanning during the previous seven years. As a comparative group, 25 cases of surgically confirmed ruptured ovarian functional cysts were included. We assessed the morphologic features of the cysts and the ancillary findings based on CT. Results For the endometriotic cysts, the mean maximum cyst diameter was significantly larger than that of the functional cysts (70.1 mm versus 36.4 mm, respectively, p < 0.05). The endometriotic cysts frequently had a multilocular shape and a thicker cyst wall, as compared to that of functional cysts, and these differences were statistically significant. Among the ancillary findings, endometriotic cysts showed a significantly higher prevalence of loculated ascites, ascites confined to the pelvic cavity without extension to the upper abdomen, and peritoneal strandings and infiltrations (p < 0.05). Although 11 of the 25 cases of functional cysts showed active extravasation of contrast material at the ovarian bleeding site, only one of 13 cases of endometriotic cysts showed active extravasation. Conclusion The diagnosis of ruptured endometriotic cyst should be suspected for a woman in whom CT reveals the presence of multilocular or bilateral ovarian cysts with a thick wall and loculated ascites confined to the pelvic cavity with pelvic fat infiltrations.
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Affiliation(s)
- Young Rae Lee
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, Korea
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136
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Tsili AC, Argyropoulou MI, Koliopoulos G, Paraskevaidis E, Tsampoulas K. Malignant transformation of an endometriotic cyst: MDCT and MR findings. J Radiol Case Rep 2011; 5:9-17. [PMID: 22470759 DOI: 10.3941/jrcr.v5i1.435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Malignant transformation is a rare complication of endometriosis. MR criteria for diagnosis include the presence of soft-tissue components, enhancement after contrast material administration in an endometriotic cyst. We present the multidetector CT and MR imaging findings in a case of an incidentally found endometrioid adenocarcinoma in a left-sided ovarian endometrioma, occurring in a 30-year old woman. MR imaging enabled the correct preoperative characterization of the lesion, by depicting a soft-tissue element, with strong and early enhancement after gadolinium administration. The same area had high signal intensity on diffusion-weighted images and low apparent diffusion coefficient values due to restricted diffusion, findings also strongly suggestive of malignancy.
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Affiliation(s)
- Athina C Tsili
- Department of Clinical Radiology, University Hospital of Ioannina, Pl. Pargis 2, Ioannina, Greece.
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137
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Koutoukos I, Langebrekke A, Young V, Qvigstad E. Imaging of endometriosis with computerized tomography colonography. Fertil Steril 2010; 95:259-60. [PMID: 20951984 DOI: 10.1016/j.fertnstert.2010.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 09/03/2010] [Indexed: 02/09/2023]
Abstract
We demonstrate the use of computerized tomography colonography for the imaging of intestinal endometriosis to facilitate preoperative management in our hospital setting.
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138
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Odobasic A, Pasic A, Iljazovic-Latifagic E, Arnautalic L, Odobasic A, Idrizovic E, Dervisefendic M, Dedić L. Perineal endometriosis: a case report and review of the literature. Tech Coloproctol 2010; 14 Suppl 1:S25-7. [DOI: 10.1007/s10151-010-0642-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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139
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Management of deep endometriosis. Reprod Biomed Online 2010; 23:25-33. [PMID: 21474383 DOI: 10.1016/j.rbmo.2010.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Revised: 08/25/2010] [Accepted: 08/26/2010] [Indexed: 11/21/2022]
Abstract
Deep endometriosis is still a challenging disease in terms of diagnosis and treatment. About 10-12% of women of reproductive age will have a form of endometriosis. This can affect pelvic as well as extra pelvic locations. Risk of malignant transformation has been studied over a long period of time. Medical and surgical treatments can be proposed to patients for endometriosis-associated pain depending on the severity of symptoms and location of the disease. Results and outcomes are different according to different publications. Understanding of the benefit of surgical treatment on fertility is increasing. The place of medical and surgical treatment in recurrent symptoms or disease is also of interest. Presented here is a review on the management of endometriosis in the light of recent data. Further investigations in many fields of endometriosis are still required.
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140
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Fambrini M, Andersson KL, Campanacci DA, Vanzi E, Bruni V, Buccoliero AM, Pieralli A, Livi L, Scarselli G. Large-muscle endometriosis involving the adductor tight compartment: case report. J Minim Invasive Gynecol 2010; 17:258-61. [PMID: 20226421 DOI: 10.1016/j.jmig.2009.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 09/15/2009] [Accepted: 12/04/2009] [Indexed: 11/26/2022]
Abstract
Extrapelvic endometriosis is an uncommon condition but can involve nearly every organ, resulting in a wide range of clinical manifestations. Herein, we describe the case of a 45-year-old woman not a candidate for hormonal therapy who had cyclic pain in the left thigh associated with progressive impairment of walking ability. Clinical, instrumental, and laboratory data supported the diagnosis of endometriosis involving the adductor muscles compartment associated with ovarian endometriomas. Laparoscopic bilateral salpingo-oophorectomy and local wide excision in collaboration with an experienced orthopedic oncologist were performed, and definitive histologic analysis confirmed the diagnosis of endometriosis. The patient was pain-free at 6-month follow-up and demonstrated substantial improvement in ambulation and quality of life. Large-muscle endometriosis is a rare entity that can compromise musculoskeletal integrity and decrease quality of life. In this case, surgical excision in collaboration with an orthopedic oncologist was the cornerstone of treatment.
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Affiliation(s)
- Massimiliano Fambrini
- Department of Gynecology, Perinatology, and Human Reproduction, University of Florence, Florence, Italy.
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141
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Nightingale AL, Ballard KD, Wright JT. Evidence-based gynaecological practice: clinical review 3. The use of imaging for pre-operative planning in deep infiltrating endometriosis involving the rectum. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s10397-010-0605-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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142
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Abstract
Discussed in this report is the use of imaging modalities to aid in the preoperative diagnosis and localization of pathology in this rare condition treated with laparoscopic hemicolectomy. Endometriosis is a disease that can affect various organs, has an unclear symptomatology, and in extreme cases, can result in intestinal obstruction. This particular case illustrates the synchronous localization of endometriosis, both genital and intestinal, resulting in ileo-colic and colonic intussusception. The relative diagnostic and therapeutic approach for such a rare occurrence is discussed.
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Affiliation(s)
- Ugo Indraccolo
- Operative Unit of Obstetrics and Gynecology, ULSS 17, Veneto, Italy.
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143
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Unusual Manifestations and Complications of Endometriosis—Spectrum of Imaging Findings:Pictorial Review. AJR Am J Roentgenol 2010; 194:WS34-46. [DOI: 10.2214/ajr.07.7142] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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144
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Imaging of Endometriosis: Self-Assessment Module. AJR Am J Roentgenol 2010; 194:S89-92. [DOI: 10.2214/ajr.07.7179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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145
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High-field magnetic resonance imaging of the pelvis: uterus, ovary, and prostate gland. Top Magn Reson Imaging 2010; 21:177-88. [PMID: 21847037 DOI: 10.1097/rmr.0b013e3181ea2a40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Today, magnetic resonance imaging (MRI) is a standard imaging modality for various pathologic disorders in the human pelvis. It has given proof of its usefulness in the diagnosis of several benign and malignant disorders, and it is routinely used for the local staging of different tumors even when confined to specific parts of a pelvic organ. Signal-to-noise ratio and motion artifacts of the examined organ and adjacent bowel structures are major factors for image quality. Setting at 3 T with surface coils avoids technical limitations and discomfort of additional endovaginal or endorectal coils. Definition of high field seems fuzzy because of the availability of MRI machines with 3, 7 T, or higher; therefore, the general aspects of MRI of pelvic structures with emphasis on uterus, ovary, and prostate gland and attention to promising newer techniques such as 3 T, dynamic contrast imaging, and diffusion-weighted imaging are reviewed in this article.
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146
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Chapron C, Chiodo I, Leconte M, Amsellem-Ouazana D, Chopin N, Borghese B, Dousset B. Severe ureteral endometriosis: the intrinsic type is not so rare after complete surgical exeresis of deep endometriotic lesions. Fertil Steril 2010; 93:2115-20. [DOI: 10.1016/j.fertnstert.2009.01.102] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Revised: 12/29/2008] [Accepted: 01/16/2009] [Indexed: 11/28/2022]
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147
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Novellas S, Chassang M, Bouaziz J, Delotte J, Toullalan O, Chevallier EP. Anterior pelvic endometriosis: MRI features. ACTA ACUST UNITED AC 2010; 35:742-9. [DOI: 10.1007/s00261-010-9600-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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148
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Nezhat C, Nicoll LM, Bhagan L, Huang JQ, Bosev D, Hajhosseini B, Beygui RE. Endometriosis of the diaphragm: four cases treated with a combination of laparoscopy and thoracoscopy. J Minim Invasive Gynecol 2009; 16:573-80. [PMID: 19835800 DOI: 10.1016/j.jmig.2009.06.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 06/05/2009] [Accepted: 06/11/2009] [Indexed: 10/20/2022]
Abstract
STUDY OBJECTIVE We aim to describe the clinical characteristics and the principles of combined laparoscopic and thoracoscopic management of women with diaphragmatic endometriosis at our institution. DESIGN Case series (Canadian Task Force Classification II2). SETTING Tertiary care referral center. PATIENTS Four women with diaphragmatic endometriosis. INTERVENTIONS Laparoscopy and thoracoscopy. MEASUREMENTS We retrospectively reviewed the charts of 4 consecutive women with diaphragmatic endometriosis who underwent laparoscopy and thoracoscopy from June 2008 through September 2008. MAIN RESULTS Four patients underwent a combination of laparoscopy for treatment of abdominopelvic endometriosis and thoracoscopy for treatment of diaphragmatic endometriosis. All patients had a history of chest pain. Three had a history of pelvic pain. Two had a history of catamenial hemothorax or pneumothorax. Two had been previously diagnosed with endometriosis, and three had a history of hormonal pharmacotherapy. All underwent laparoscopy and thoracoscopy without complications. All had uneventful recoveries. At nine-month follow-up, all patients were free of chest pain, and one patient had recurring pelvic pain. CONCLUSIONS To the best of our knowledge, this constitutes the only reported series of patients with endometriosis who underwent a procedure systematically combining both laparoscopy and thoracoscopy for treatment of abdominopelvic and thoracic disease. It confirms that combined laparoscopic and thoracoscopic diagnosis and management of diaphragmatic endometriosis is reasonable. The inferior aspect of the diaphragm should be evaluated in all patients undergoing laparoscopy for endometriosis. Concomitant thoracoscopy should be considered for all patients with history of catamenial hemopneumothorax, cyclic chest or shoulder pain, or cyclic dyspnea. The aim of treatment should be to remove endometriotic lesions, to provide symptomatic relief, and to avoid recurrence. The use of these minimally invasive techniques may reduce the need for laparotomy or thoracotomy in affected patients.
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Affiliation(s)
- Camran Nezhat
- Center for Special Minimally Invasive Surgery, Stanford University Medical Center, Palo Alto, California 94304, USA.
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149
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150
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Bosev D, Nicoll LM, Bhagan L, Lemyre M, Payne CK, Gill H, Nezhat C. Laparoscopic Management of Ureteral Endometriosis: The Stanford University Hospital Experience With 96 Consecutive Cases. J Urol 2009; 182:2748-52. [DOI: 10.1016/j.juro.2009.08.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Dorian Bosev
- Center for Special Minimally Invasive Surgery and Department of Urology, Stanford University Medical Center, Palo Alto, California, Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University, Maichin Dom Hospital, Sofia, Bulgaria, Department of Obstetrics and Gynecology, Faculty of Medicine, Laval University, Quebec, Ontario, Canada
| | - Linda M. Nicoll
- Center for Special Minimally Invasive Surgery and Department of Urology, Stanford University Medical Center, Palo Alto, California, Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University, Maichin Dom Hospital, Sofia, Bulgaria, Department of Obstetrics and Gynecology, Faculty of Medicine, Laval University, Quebec, Ontario, Canada
| | - Lisa Bhagan
- Center for Special Minimally Invasive Surgery and Department of Urology, Stanford University Medical Center, Palo Alto, California, Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University, Maichin Dom Hospital, Sofia, Bulgaria, Department of Obstetrics and Gynecology, Faculty of Medicine, Laval University, Quebec, Ontario, Canada
| | - Madeleine Lemyre
- Center for Special Minimally Invasive Surgery and Department of Urology, Stanford University Medical Center, Palo Alto, California, Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University, Maichin Dom Hospital, Sofia, Bulgaria, Department of Obstetrics and Gynecology, Faculty of Medicine, Laval University, Quebec, Ontario, Canada
| | - Christopher K. Payne
- Center for Special Minimally Invasive Surgery and Department of Urology, Stanford University Medical Center, Palo Alto, California, Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University, Maichin Dom Hospital, Sofia, Bulgaria, Department of Obstetrics and Gynecology, Faculty of Medicine, Laval University, Quebec, Ontario, Canada
| | - Harcharan Gill
- Center for Special Minimally Invasive Surgery and Department of Urology, Stanford University Medical Center, Palo Alto, California, Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University, Maichin Dom Hospital, Sofia, Bulgaria, Department of Obstetrics and Gynecology, Faculty of Medicine, Laval University, Quebec, Ontario, Canada
| | - Camran Nezhat
- Center for Special Minimally Invasive Surgery and Department of Urology, Stanford University Medical Center, Palo Alto, California, Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University, Maichin Dom Hospital, Sofia, Bulgaria, Department of Obstetrics and Gynecology, Faculty of Medicine, Laval University, Quebec, Ontario, Canada
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