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AIUM Practice Parameter for the Performance of Ultrasound of the Female Pelvis, 2024 Revision. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024. [PMID: 39158217 DOI: 10.1002/jum.16556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 08/07/2024] [Indexed: 08/20/2024]
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2
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Lamoutte CM, Burke NR, Shwayder JM, O'Shea T, Johnson SE. Misdiagnosed plicae palmatae. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 63:565-567. [PMID: 37820060 DOI: 10.1002/uog.27511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/30/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023]
Affiliation(s)
- C M Lamoutte
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - N R Burke
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - J M Shwayder
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - T O'Shea
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - S E Johnson
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL, USA
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3
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Petre I, Sirbu DT, Petrita R, Toma AD, Peta E, Dimcevici-Poesina F. Real‑world study of Cerviron ® vaginal ovules in the treatment of cervical lesions of various etiologies. Biomed Rep 2023; 19:54. [PMID: 37546352 PMCID: PMC10398350 DOI: 10.3892/br.2023.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/15/2023] [Indexed: 08/08/2023] Open
Abstract
Cervical lesions can be caused by pathogens, hormonal changes or by cervical injury. The recommended treatment in all cases is excision. Local re-epithelialization therapy should be initiated preoperatively and postoperatively. The present study assessed the post-market performance and tolerability of Cerviron® ovules in the treatment and management of cervical lesions postoperatively. The study population included 345 participants aged 20-70 years with either a cervical lesion under treatment or with recent surgical removal of a cervical lesion. The degree of re-epithelialization of the cervical mucosa was improved in 73.17% of the patients evaluated during routine colposcopy exams and 92.73% of patients recorded no bleeding. When adding Cerviron® either as monotherapy or in association with other antimicrobials in postoperative care of the cervical ectropion, improved postoperative outcomes such as reduced post-interventional bleeding and a superior quality of healing were observed. The study and its details are registered in www.clinicaltrials.gov under ID NCT05668806.
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Affiliation(s)
- Izabella Petre
- Discipline of Obstetrics and Gynecology XII, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
- University Clinic of Obstetrics and Gynecology, Emergency Clinic Hospital ‘Pius Brinzeu’, 300226 Timisoara, Romania
| | | | - Ramona Petrita
- Biometrics Unit, MDX Research, 300633 Timisoara, Romania
| | - Andreea-Denisa Toma
- Pharmacy Unit of Municipal Hospital ‘Dr Karl Diel’ Jimbolia, 305400 Jimbolia, Romania
| | - Ema Peta
- Quality Assurance, Perfect Care Distribution SRL, 011158 Bucharest, Romania
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4
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Cooper E, Ekram S, Hartrich M. A Woman With Decreased Urine Output. Ann Emerg Med 2023; 82:e73-e74. [PMID: 37479415 DOI: 10.1016/j.annemergmed.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 07/23/2023]
Affiliation(s)
- Eric Cooper
- Department of Emergency Medicine, University of Illinois Health, Chicago, IL
| | - Sahrish Ekram
- Department of Emergency Medicine, University of Illinois Health, Chicago, IL
| | - Molly Hartrich
- Department of Emergency Medicine, University of Illinois Health, Chicago, IL
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5
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Aswani Y, Saifi S. Arbor Vitae Uteri. Indian J Radiol Imaging 2022; 32:627-628. [DOI: 10.1055/s-0042-1755252] [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] Open
Affiliation(s)
- Yashant Aswani
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
| | - Shenaz Saifi
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
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6
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Lūse L, Urtāne AĶ, Lisovaja I, Jermakova I, Donders GGG, Vedmedovska N. Literature Review of Cervical Regeneration after Loop Electrosurgical Excision Procedure, and Study Project (CeVaLEP) Proposal. J Clin Med 2022; 11:jcm11082096. [PMID: 35456188 PMCID: PMC9030886 DOI: 10.3390/jcm11082096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023] Open
Abstract
Objective: To compile existing knowledge on the level of cervical regeneration (detected by ultrasound) after loop electrosurgical excision procedure (LEEP) and to suggest research protocol for further studies. Methods: We conducted a literature search of Medline, Web of Science, Scopus, and Cochrane databases using the keywords “cervix” and “regeneration” without year restrictions. Our eligibility criteria included studies that analysed cervical volume and length regeneration using ultrasound. A literature review was conducted following PRISMA guidelines and registered in PROSPERO (reg. no. CRD42021264062). Information about the studies was extracted from each analysed study on an Excel datasheet and the average regeneration with standard deviation was calculated. All included studies’ possible biases were assessed by the National Institutes of Health’s (NIH) quality assessment tool. Results: The literature search identified 802 papers and four trials (n = 309) that met our criteria. They investigated cervical length and volume regeneration after LEEP using ultrasound, concluding that there is a profound regeneration deficit. Average cervical length regeneration after 6 months was 83.4% (±10.8%) and volume regeneration was 87.4% (±6.1%). All analysed studies had their biases; therefore, based on the conducted studies’ protocols, we present a CeVaLEP research protocol to guide high-quality studies. Conclusion: After LEEP, there is a cervical regeneration deficit. There is a lack of high-quality studies that assess cervical volume regeneration and its relation to obstetrical outcomes. There is a gap in the field and more research is needed to define the prenatal risks related to cervical regeneration.
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Affiliation(s)
- Laura Lūse
- Faculty of Residency, Rīga Stradiņš University, LV-1007 Riga, Latvia;
- Correspondence:
| | - Anda Ķīvīte Urtāne
- Department of Public Health and Epidemiology, Rīga Stradiņš University, LV-1007 Riga, Latvia;
| | - Ija Lisovaja
- Faculty of Residency, Rīga Stradiņš University, LV-1007 Riga, Latvia;
| | - Irina Jermakova
- Gynecology Department, Riga Eastern Clinical University Hospital, LV-1079 Riga, Latvia;
| | - Gilbert G. G. Donders
- Department OB/Gyn, Antwerp University Hospital, 2650 Edegem, Belgium;
- Femicare VZW, Clinical Research for Women, 3300 Tienen, Belgium
| | - Natālija Vedmedovska
- Department of Obstetrics and Gynecology, Rīga Stradiņš University, LV-1007 Riga, Latvia;
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7
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Huang L, Liu B, Liu Z, Feng W, Liu M, Wang Y, Peng D, Fu X, Zhu H, Cui Z, Xie L, Ma Y. Gut Microbiota Exceeds Cervical Microbiota for Early Diagnosis of Endometriosis. Front Cell Infect Microbiol 2021; 11:788836. [PMID: 34950610 PMCID: PMC8688745 DOI: 10.3389/fcimb.2021.788836] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/02/2021] [Indexed: 12/18/2022] Open
Abstract
The diagnosis of endometriosis is typically delayed by years for the unexclusive symptom and the traumatic diagnostic method. Several studies have demonstrated that gut microbiota and cervical mucus potentially can be used as auxiliary diagnostic biomarkers. However, none of the previous studies has compared the robustness of endometriosis classifiers based on microbiota of different body sites or demonstrated the correlation among microbiota of gut, cervical mucus, and peritoneal fluid of endometriosis, searching for alternative diagnostic approaches. Herein, we enrolled 41 women (control, n = 20; endometriosis, n = 21) and collected 122 well-matched samples, derived from feces, cervical mucus, and peritoneal fluid, to explore the nature of microbiome of endometriosis patients. Our results indicated that microbial composition is remarkably distinguished between three body sites, with 19 overlapped taxa. Moreover, endometriosis patients harbor distinct microbial communities versus control group especially in feces and peritoneal fluid, with increased abundance of pathogens in peritoneal fluid and depletion of protective microbes in feces. Particularly, genera of Ruminococcus and Pseudomonas were identified as potential biomarkers in gut and peritoneal fluid, respectively. Furthermore, novel endometriosis classifiers were constructed based on taxa selected by a robust machine learning method. These results demonstrated that gut microbiota exceeds cervical microbiota in diagnosing endometriosis. Collectively, this study reveals important insights into the microbial profiling in different body sites of endometriosis, which warrant future exploration into the role of microbiota in endometriosis and highlighted values on gut microbiota in early diagnosis of endometriosis.
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Affiliation(s)
- Liujing Huang
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Bingdong Liu
- Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhihong Liu
- Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Wanqin Feng
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Minjuan Liu
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yifeng Wang
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Dongxian Peng
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiafei Fu
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Honglei Zhu
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zongbin Cui
- Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Liwei Xie
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
- College of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Ying Ma
- Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Patel SK, Valicherla GR, Micklo AC, Rohan LC. Drug delivery strategies for management of women's health issues in the upper genital tract. Adv Drug Deliv Rev 2021; 177:113955. [PMID: 34481034 DOI: 10.1016/j.addr.2021.113955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/23/2021] [Accepted: 08/28/2021] [Indexed: 02/08/2023]
Abstract
The female upper genital tract (UGT) hosts important reproductive organs including the cervix, uterus, fallopian tubes, and ovaries. Several pathologies affect these organ systems such as infections, reproductive issues, structural abnormalities, cancer, and inflammatory diseases that could have significant impact on women's overall health. Effective disease management is constrained by the multifaceted nature of the UGT, complex anatomy and a dynamic physiological environment. Development of drug delivery strategies that can overcome mucosal and safety barriers are needed for effective disease management. This review introduces the anatomy, physiology, and mucosal properties of the UGT and describes drug delivery barriers, advances in drug delivery technologies, and opportunities available for new technologies that target the UGT.
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Gulati S, Rathi V, Jain S, Bhatt S. Incidentalomas of the female genital tract on 64-slice MDCT: a clinico-radiological pictorial review. Abdom Radiol (NY) 2021; 46:4420-4431. [PMID: 33890122 DOI: 10.1007/s00261-021-03086-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/01/2021] [Accepted: 04/09/2021] [Indexed: 11/27/2022]
Abstract
Sonography is the imaging modality of choice for diagnosing diseases of the female genital tract due to its high resolution, easy availability, low cost and lack of radiation. CT is not advocated for the primary evaluation of the female pelvis. However, with the advent of Multidetector CT (MDCT), females of all ages undergo CT scan of the abdomen and pelvis for myriad non-gynaecological diseases, e.g. subacute intestinal obstruction, abdominal lump, abdominal tuberculosis, appendicitis, ureteric colic, pancreatitis, oncological staging, follow-up, etc. Incidental female genital tract disorders were seen on these scans that are a dilemma for both, the radiologists and the clinicians. The objective of this pictorial review is to characterise the incidentally detected lesions of the female genital tract observed on 64-slice MDCT by correlating with sonography, if necessary, and establishing a clinico-radiological diagnosis. Our aim is to emphasise that the radiologist may be the first person to recognise a gynaecologic disorder and hence can play a significant role in patient management.
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Affiliation(s)
- Shrea Gulati
- Department of Radio Diagnosis, University College of Medical Sciences, Delhi, India
| | - Vinita Rathi
- Department of Radio Diagnosis, University College of Medical Sciences & GTB Hospital, 89/2 Radhey Puri Extension-II, Delhi, 110051, India.
| | - Sandhya Jain
- Department of Obstetrics & Gynaecology, University College of Medical Sciences, Delhi, India
| | - Shuchi Bhatt
- Department of Radio Diagnosis, University College of Medical Sciences, Delhi, India
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10
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Fitzpatrick A, DiGiacinto D. Comparison of Transabdominal and Transvaginal Sonograms in Evaluation of Cervical Length During Pregnancy. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2021. [DOI: 10.1177/87564793211012612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: A short cervix during pregnancy indicates a higher risk of preterm delivery. Transvaginal sonography is widely used for the detection of a short cervix. The literature indicates that 21–24 weeks is the most sensitive gestational age to assess transvaginal cervical length (TV CL) of ≤2.5 cm for potential preterm delivery. Pregnancies between 18 and 20 weeks’ gestation are generally performed transabdominally; thus, it could be beneficial to have a recognized correlation between the transabdominal cervical length (TA CL) measurement and the TV CL measurement at this earlier time period. Materials and Methods: An online database search produced 13 research articles to be reviewed. Inclusion criteria consisted of TA CL and TV CL assessment of singleton pregnancies with intact membranes. Results: Findings indicate high diagnostic yield when a TA CL of <2.9 cm or TV CL of <2.5 cm is used for defining a shortened cervix when measured between 18 and 20 weeks’ gestation. Conclusion: This review of the literature indicates a correlation between average TA CL and average TV CL measurements, although the relationship widens as CLs become shorter.
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Affiliation(s)
| | - Dora DiGiacinto
- Medical Imaging and Radiation Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Abstract
The role of hybrid imaging with 2-[18F] flourodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) is continuously evolving and now considered standard practice in evaluation of disease stage, treatment response, recurrent disease and follow-up for numerous primary malignancies. In gynecological malignancies FDG PET/CT plays an important role, not only in the assessment of disease in the pre-and post-therapy setting, but also in radiation therapy (RT) planning by defining the metabolically active gross tumor volume (GTV. The glucose analogue radiotracer, FDG, is by far the most utilized radiotracer in PET/CT and is typically seen with high uptake in malignant cells. The radiotracer FDG has a high sensitivity but low specificity for malignancy, as benign processes with an inflammatory response for example infection, are also FDG-avid. In the evaluation of the female pelvic region an awareness of potential confounding factors in the interpretation of FDG is essential as variations of FDG uptake occur in accordance with the menstrual cycle and the menopausal state. Incidental imaging findings in the female genital can pose differential diagnostic challenges as false-positive and false-negative findings in benign and malignant processes are not uncommon. Gynecological malignancies continue to pose major public health problems with cervical cancer as the fourth most common cancer in women ranking after breast cancer, colorectal cancer and lung cancer. Familiarity with frequently encountered benign and malignant variants and pitfalls in FDG PET/CT in the female pelvic region can aid the reader in differential diagnostic considerations.
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Affiliation(s)
- Danijela Dejanovic
- Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
| | - Naja Liv Hansen
- Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Annika Loft
- Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
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Congenital Obstructive Müllerian Anomaly: The Pitfalls of a Magnetic Resonance Imaging-Based Diagnosis and the Importance of Intraoperative Biopsy. J Clin Med 2021; 10:jcm10112414. [PMID: 34072446 PMCID: PMC8198439 DOI: 10.3390/jcm10112414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022] Open
Abstract
A retrospective cohort study of the concordance between the magnetic resonance imaging (MRI) diagnosis and final diagnosis in patients with Müllerian duct anomalies (MDAs) was conducted, and diagnostic clues were suggested. A total of 463 cases of young women who underwent pelvic MRIs from January 1995 to February 2019 at Seoul Asan Medical Center were reviewed. Interventions consisted of clinical examinations, abdominal or transvaginal/rectal ultrasound, MRI, and operative procedures, including hysteroscopy and laparoscopy. The concordance of the diagnosis between the results obtained with MRI and those obtained with surgeries was evaluated. It was found that a total of 225 cases (48.6%) showed genital tract anomalies on MRI. Among them, 105 cases (46.7%) underwent reconstructive surgery. Nineteen cases (8.4%) revealed discrepancies between the final diagnosis after surgery and the initial MRI findings and eleven cases (57.9%) had cervical anomalies. Incorrect findings associated with the MRIs were particularly evident in biopsied cases of cervical dysgenesis. A combination of physical examination, ultrasound, and MRI is suitable for preoperative work-up in the diagnoses of congenital obstructive anomalies. However, it is recommended that a pathologic confirmation of tissue at the caudal leading edge be made in obstructive genital anomalies, in cases of presumptive vaginal or cervical dysgenesis.
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Shroff N, Bhargava P. Giant nabothian cysts: A rare incidental diagnosis on MRI. Radiol Case Rep 2021; 16:1473-1476. [PMID: 33936352 PMCID: PMC8079239 DOI: 10.1016/j.radcr.2021.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 11/19/2022] Open
Abstract
This case report follows a 52-year-old female patient undergoing routine screening for hepatocellular carcinoma. Incidentally, the patient was found to have a cystic pelvic mass on initial imaging via CT. Subsequent imaging with MR confirmed findings of two giant nabothian cysts. This case outlines the rare, asymptomatic nature of giant nabothian cysts and emphasizes the efficacy of MR as a tool for diagnosis of pelvic masses when ultrasound and CT findings are equivocal.
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Oh H, Park SB, Park HJ, Lee ES, Hur J, Choi W, Choi BI. Ultrasonographic features of uterine cervical lesions. Br J Radiol 2021; 94:20201242. [PMID: 33560888 DOI: 10.1259/bjr.20201242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Currently, ultrasound (US) is a valuable imaging tool for the initial assessment and evaluation of the female genital organs, uterus, and adnexa. However, it is easy to overlook the uterine cervix while conducting a pelvic US. Uterine cervical lesions may range from benign to malignant in nature. Therefore, meticulous examination with US may play a key role in assessing uterine cervical lesions. Although there is substantial overlap in the US findings across various uterine cervical lesions, some US features, in tandem with clinical characteristics, may suggest a specific diagnosis. Familiarity with the clinical settings and US characteristics of different uterine cervical lesions can support prompt and accurate diagnosis of suspicious lesions. This review article aims to describe the features of US and possible values for distinction of these lesions in the uterine cervix.
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Affiliation(s)
- Hyunji Oh
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Hyun Jeong Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Eun Sun Lee
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Joonho Hur
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Woosun Choi
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
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15
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AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Female Pelvis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:E17-E23. [PMID: 32150295 DOI: 10.1002/jum.15205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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16
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Abu Hashim H, Al Khiary M, El Rakhawy M. Laparotomic myomectomy for a huge cervical myoma in a young nulligravida woman: A case report and review of the literature. Int J Reprod Biomed 2020; 18:135-144. [PMID: 32259008 PMCID: PMC7097170 DOI: 10.18502/ijrm.v18i2.6421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/06/2019] [Accepted: 09/17/2019] [Indexed: 12/23/2022] Open
Abstract
Background A huge cervical myoma (rare) in a young woman is a nightmare of every gynecologist owing to the associated technical challenges in performing a myomectomy. Moreover, the 2014 US Food and Drug Administration prohibited power morcellation during laparoscopic myomectomy due to the inadvertent spread of occult malignancy and an increased risk of iatrogenic parasitic leiomyoma negatively affected the overall rate of a minimally invasive surgery. Case This report described our experience with a case of a huge anterior cervical myoma (473 gr) in a young nulligravida woman who successfully underwent laparotomic myomectomy. After an initial diagnosis by Magnetic resonance imaging (MRI), we performed preoperative ureteric catheterization. The myoma was enucleated following the footsteps of Victor Bonney, the pioneer of myomectomy, combined with simple additional steps. We did not use preoperative gonadotropin-releasing hormone analog, intraoperative vasopressin injection, or uterine artery ligation. A 6-month follow-up MRI revealed an intact cervical canal in midline position with no evidence of residual fibroid. Conclusion Based on our experience, the review of the relevant literature, and the US Food and Drug Administration's prohibition of power morcellation during laparoscopic myomectomy, a laparotomic myomectomy for a huge cervical myoma still plays a vital role in fertility preservation. We propose the mnemonic "MUSIC" as a helpful guide for a consistent strategy: M (preoperative MRI), U (prophylactic ureteric catheterization), S (shell out the myoma following Bonney's principles i.e. start-up and stay intracapsular), I (immediate suction to clarify dead space) and C (close the cavity by spiraling stitch).
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Affiliation(s)
- Hatem Abu Hashim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Moustafa Al Khiary
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed El Rakhawy
- Department of Diagnostic Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Korhonen KE, Pantel AR, Mankoff DA. 18F-FDG-PET/CT in Breast and Gynecologic Cancer. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_20] [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]
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18
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Abstract
This article provides an overview of ultrasonographic evaluation of the normal female pelvis. Pertinent pelvic anatomy is reviewed, and there is an in-depth discussion of the normal appearance of the uterus and ovaries. In addition, the indications and technique for performing 3-dimensional imaging and saline-infused sonohysterography are covered.
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Abstract
Pelvic ultrasound examination is the primary imaging modality for evaluating a wide range of female pelvic symptomatology, and is often the first imaging test to detect a gynecologic malignancy. Ultrasound imaging is particularly useful for evaluating the thickness and appearance of the endometrium in patients with abnormal bleeding, and in detecting and characterizing ovarian lesions. This article reviews the ultrasound appearance of gynecologic neoplasms grouped by anatomic site of origin, the ultrasound appearance of select benign pelvic pathology not to be misinterpreted as malignancy, as well as available ultrasound imaging-based guidelines for managing potential gynecologic neoplasms.
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Budden A, Abbott JA. The Diagnosis and Surgical Approach of Uterine Septa. J Minim Invasive Gynecol 2017; 25:209-217. [PMID: 28755995 DOI: 10.1016/j.jmig.2017.07.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 12/14/2022]
Abstract
Uterine septa are a class of müllerian duct anomaly that, similar to other classes, are associated with poor reproductive outcomes; however, they are unique because these poor outcomes, particularly recurrent pregnancy loss, may be responsive to surgical correction. The current evidence regarding septoplasty is difficult to interpret because the definitions of a uterine septum, methods to diagnose it, and hysteroscopic techniques used for treatment are variable and generally of poor to moderate quality. Robust data on outcomes, particularly live births, after septoplasty are not available at this time. This review aims to examine the evidence on this contentious issue. A search of the literature was conducted using the MEDLINE, Embase, and Cochrane databases from 2002 to present with included articles reporting on clinical and/or imaging diagnosis of a uterine septum, operative techniques for uterine septoplasty, or clinical outcomes for women with uterine septa. The initial search revealed 4997 potentially relevant articles with 36 full-text articles included after the removal of nonrelevant titles, including 16 diagnostic studies, 17 surgical studies, and 3 studies on clinical outcomes. Where access to 3-dimensional transvaginal ultrasound or magnetic resonance imaging exists, these imaging modalities offer a highly sensitive and specific method of diagnosing a uterine septum without invasive diagnosis although this is operator dependent. Despite hysteroscopic septoplasty being described for over 40 years, there remains a lack of high-quality data to support hysteroscopic septoplasty and which women would most benefit from the procedure. There is no evidence for pre- or postoperative treatments nor has a single surgical approach been identified as superior than another although an important end point of live birth rates is largely unreported in these trials. Although several classification systems have been described, the diagnostic categorization of septal variants has limited a meaningful approach to this issue in both the clinical and research setting.
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Affiliation(s)
- Aaron Budden
- School of Women's and Children's Health, University of New South Wales and Department of Gynaecology, Royal Hospital for Women, Sydney, Australia
| | - Jason A Abbott
- School of Women's and Children's Health, University of New South Wales and Department of Gynaecology, Royal Hospital for Women, Sydney, Australia.
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Horrow MM. Invited Commentary on “US of the Nongravid Cervix with Multimodality Imaging Correlation”. Radiographics 2016; 36:617-9. [DOI: 10.1148/rg.2016160001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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