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Yoeli-Bik R, Lengyel E, Mills KA, Abramowicz JS. Ovarian Masses: The Value of Acoustic Shadowing on Ultrasound Examination. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:935-945. [PMID: 36114807 DOI: 10.1002/jum.16100] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Adnexal lesions are a common finding in women and pose a clinical challenge since ovarian cancer is a highly lethal disease. However, most adnexal masses are benign, benefiting from a more conservative approach. In preoperative assessment, transvaginal ultrasound plays a key role in evaluating morphologic features that correlate with the risk of malignancy. The acoustic shadow is the loss of echo behind sound-absorbing components, such as calcifications or fibrous tissues, which are predominantly found in benign lesions. However, recognizing the acoustic shadow is a difficult skill to master, and its usefulness may be underappreciated.
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Affiliation(s)
- Roni Yoeli-Bik
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, University of Chicago, Chicago, Illinois, USA
| | - Ernst Lengyel
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, University of Chicago, Chicago, Illinois, USA
| | - Kathryn A Mills
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, University of Chicago, Chicago, Illinois, USA
| | - Jacques S Abramowicz
- Department of Obstetrics and Gynecology/Section of Maternal Fetal Medicine, University of Chicago, Chicago, Illinois, USA
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Rana SS, Bush N, Gupta R. Transrectal endoscopic ultrasound in undiagnosed ascites: is it a peritoneal deposit? Endoscopy 2022; 54:E22-E23. [PMID: 33607662 DOI: 10.1055/a-1353-4637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Surinder S Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nikhil Bush
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rajesh Gupta
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Role of Combining Colour Doppler and Grey Scale Ultrasound in Differentiating Benign from Malignant Ovarian Masses. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2020. [DOI: 10.2478/sjecr-2018-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
The aim of this study was to evaluate ovarian masses with conventional grey scale ultrasonography and colour Doppler flow imaging and to assess the diagnostic reliability of these methods in differentiating benign and malignant ovarian masses.
We assessed 56 patients with an ovarian mass. Morphological characterisation of the mass was performed utilising the Sassone score. Colour Doppler parameters were recorded for each patient, and the Caruso vascular score was also applied. The results were compared with surgical/pathological and/or follow-up scans.
Using the Sassone score, overall reliability in differentiating ovarian masses had a sensitivity of 89.5% and a specificity of 78.4%. Using the Caruso score alone, we found a sensitivity of 89.5% and a specificity of 86.5%. Using the Sassone and Caruso scores together, we found a sensitivity of 94.7% and a specificity of 89.1%.
Combining both morphological and colour Doppler scores in the evaluation of ovarian masses obtained higher specificity, sensitivity, and accuracy than was obtained using a single score only.
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Jeong SY, Kim TJ, Park BK. Epithelial ovarian cancer: a review of preoperative imaging features indicating suboptimal surgery. J Gynecol Oncol 2020; 31:e57. [PMID: 32347021 PMCID: PMC7286754 DOI: 10.3802/jgo.2020.31.e57] [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: 02/14/2020] [Revised: 03/05/2020] [Accepted: 03/08/2020] [Indexed: 11/30/2022] Open
Abstract
Epithelial ovarian cancer has been traditionally treated with cytoreductive surgery and chemotherapy. Optimal surgery is the key to improving the prognosis, and, thus, preoperative imaging should be carefully assessed to determine if the involvement of gastrointestinal, vascular, or thoracic surgeons is necessary to achieve this. Consequently, gynecologists should be able to recognize which imaging features suggest optimal or suboptimal resection. The aim of this review was to present the preoperative imaging features indicating suboptimal resection of epithelial ovarian cancer.
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Affiliation(s)
- Soo Young Jeong
- Department of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Joong Kim
- Department of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Kwan Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Abstract
This article provides an overview of the imaging evaluation of benign ovarian and adnexal masses in premenopausal and postmenopausal women and lesions discovered during pregnancy. Current imaging techniques are discussed, including pitfalls and differential diagnosis when necessary, as well as management. It also reviews the now well-established American College of Radiology (ACR)/Society of Radiologists in Ultrasound consensus guidelines and covers the more recently introduced Ovarian-Adnexal Reporting and Data System by the ACR and the recently published ADNEx Scoring System.
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Affiliation(s)
- Nadia J Khati
- Department of Radiology, Abdominal Imaging Section, The George Washington University Hospital, 900 23rd Street, Northwest, Washington, DC 20037, USA.
| | - Tammy Kim
- Department of Radiology, Abdominal Imaging Section, The George Washington University Hospital, 900 23rd Street, Northwest, Washington, DC 20037, USA
| | - Joanna Riess
- Department of Radiology, Abdominal Imaging Section, The George Washington University Hospital, 900 23rd Street, Northwest, Washington, DC 20037, USA
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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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Sintim-Damoa A, Majmudar AS, Cohen HL, Parvey LS. Pediatric Ovarian Torsion: Spectrum of Imaging Findings. Radiographics 2017; 37:1892-1908. [DOI: 10.1148/rg.2017170026] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Akosua Sintim-Damoa
- From the Department of Radiology, LeBonheur Children’s Hospital, University of Tennessee Health Science Center, 848 Adams Ave, Memphis, TN 38103
| | - Anand Shyamcharan Majmudar
- From the Department of Radiology, LeBonheur Children’s Hospital, University of Tennessee Health Science Center, 848 Adams Ave, Memphis, TN 38103
| | - Harris L. Cohen
- From the Department of Radiology, LeBonheur Children’s Hospital, University of Tennessee Health Science Center, 848 Adams Ave, Memphis, TN 38103
| | - Louis Swig Parvey
- From the Department of Radiology, LeBonheur Children’s Hospital, University of Tennessee Health Science Center, 848 Adams Ave, Memphis, TN 38103
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9
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Emergent ultrasound evaluation of the pediatric female pelvis. Pediatr Radiol 2017; 47:1134-1143. [PMID: 28779190 DOI: 10.1007/s00247-017-3843-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 02/13/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
Ultrasound is the primary imaging modality of the pediatric female pelvis and is often requested to evaluate girls with pelvic or abdominal pain or abnormal bleeding. The US interpretation can help guide the clinician toward medical or surgical management. Here we discuss the normal US anatomy of the female pelvis and illustrate, through case examples, conditions encountered when performing emergent pelvic US for common and uncommon clinical scenarios.
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Rivera Domínguez A, Mora Jurado A, García de la Oliva A, de Araujo Martins-Romeo D, Cueto Álvarez L. Gynecological pelvic pain as emergency pathology. RADIOLOGIA 2017. [DOI: 10.1016/j.rxeng.2016.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rivera Domínguez A, Mora Jurado A, García de la Oliva A, de Araujo Martins-Romeo D, Cueto Álvarez L. Gynecological pelvic pain as emergency pathology. RADIOLOGIA 2016; 59:115-127. [PMID: 27979433 DOI: 10.1016/j.rx.2016.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 09/19/2016] [Accepted: 09/30/2016] [Indexed: 11/17/2022]
Abstract
Acute pelvic pain is a common condition in emergency. The sources of acute pelvic pain are multifactorial, so it is important to be familiar with this type of pathologies. The purpose of this article is review the main causes of gynecological acute pelvic pain and their radiologic appearances to be able to make an accurate diagnosis and provide objective criteria for patient management.
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Affiliation(s)
- A Rivera Domínguez
- Unidad de Gestión Clínica de Radiodiagnóstico. Hospital Universitario Virgen Macarena, Sevilla, España.
| | - A Mora Jurado
- Unidad de Gestión Clínica de Radiodiagnóstico. Hospital Universitario Virgen Macarena, Sevilla, España
| | - A García de la Oliva
- Unidad de Gestión Clínica de Radiodiagnóstico. Hospital Universitario Virgen Macarena, Sevilla, España
| | - D de Araujo Martins-Romeo
- Unidad de Gestión Clínica de Radiodiagnóstico. Hospital Universitario Virgen Macarena, Sevilla, España
| | - L Cueto Álvarez
- Unidad de Gestión Clínica de Radiodiagnóstico. Hospital Universitario Virgen Macarena, Sevilla, España
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Katabathina VS, Amanullah FS, Menias CO, Chen MM, Valente PT, Chintapalli KN, Prasad SR. Extrauterine Pelvic Serous Carcinomas: Current Update on Pathology and Cross-sectional Imaging Findings. Radiographics 2016; 36:918-32. [DOI: 10.1148/rg.2016150130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
Premenopausal women with acute pelvic pain comprise a significant percentage of patients who present to the emergency room. Etiologies can be gynecologic, urologic, gastrointestinal, or vascular. Signs and symptoms are often nonspecific and overlapping. The choice of imaging modality is determined by the clinically suspected differential diagnosis. Ultrasound (US) is the preferred imaging modality for suspected obstetric or gynecologic disorders. CT is more useful when gastrointestinal or urinary tract pathology is likely. MR imaging is rarely used in the emergent setting, except to exclude appendicitis in pregnant women. This article presents a comprehensive review of imaging of acute gynecologic disorders.
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Affiliation(s)
- Carolyn K Donaldson
- Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL 60201, USA.
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Jung SI. Ultrasonography of ovarian masses using a pattern recognition approach. Ultrasonography 2015; 34:173-82. [PMID: 25797108 PMCID: PMC4484293 DOI: 10.14366/usg.15003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/06/2015] [Accepted: 02/07/2015] [Indexed: 12/26/2022] Open
Abstract
As a primary imaging modality, ultrasonography (US) can provide diagnostic information for evaluating ovarian masses. Using a pattern recognition approach through gray-scale transvaginal US, ovarian masses can be diagnosed with high specificity and sensitivity. Doppler US may allow ovarian masses to be diagnosed as benign or malignant with even greater confidence. In order to differentiate benign and malignant ovarian masses, it is necessary to categorize ovarian masses into unilocular cyst, unilocular solid cyst, multilocular cyst, multilocular solid cyst, and solid tumor, and then to detect typical US features that demonstrate malignancy based on pattern recognition approach.
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Affiliation(s)
- Sung Il Jung
- Department of Radiology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
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Lopes Dias J, Cunha TM, Gomes FV, Callé C, Félix A. Neuroendocrine tumours of the female genital tract: a case-based imaging review with pathological correlation. Insights Imaging 2015; 6:43-52. [PMID: 25592289 PMCID: PMC4330232 DOI: 10.1007/s13244-014-0378-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/04/2014] [Accepted: 12/11/2014] [Indexed: 01/02/2023] Open
Abstract
Background Both primary and secondary gynaecological neuroendocrine (NE) tumours are uncommon, and the literature is scarce concerning their imaging features. Methods This article reviews the epidemiological, clinical and imaging features with pathological correlation of gynaecological NE tumours. Results The clinical features of gynaecological NE tumours are non-specific and depend on the organ of origin and on the extension and aggressiveness of the disease. The imaging approach to these tumours is similar to that for other histological types and the Revised International Federation of Gynecology and Obstetrics (FIGO) Staging System also applies to NE tumours. Neuroendocrine tumours were recently divided into two groups: poorly differentiated neuroendocrine carcinomas (NECs) and well-differentiated neuroendocrine tumours (NETs). NECs include small cell carcinoma and large cell neuroendocrine carcinoma, while NETs account for typical and atypical carcinoids. Cervical small cell carcinoma and ovarian carcinoid are the most common gynaecological NE tumours. The former typically behaves aggressively; the latter usually behaves in a benign fashion and tends to be confined to the organ. Conclusion While dealing with ovarian carcinoids, extra-ovarian extension, bilaterality and multinodularity raise the suspicion of metastatic disease. NE tumours of the endometrium and other gynaecological locations are very rare. Teaching Points • Primary or secondary neurondocrine (NE) tumours of the female genital tract are rare. • Cervical small cell carcinoma and ovarian carcinoids are the most common gynaecological NE tumours. • Cervical small cell carcinomas usually behave aggressively. • Ovarian carcinoids tend to behave in a benign fashion. • The imaging approach to gynaecological NE tumours and other histological types is similar.
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Affiliation(s)
- João Lopes Dias
- Department of Radiology, Hospital de São José, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Teresa Margarida Cunha
- Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | | | - Catarina Callé
- Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Ana Félix
- Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
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Hui JS, Kramer DJ, Blackmore CC, Hashimoto BE, Coy DL. A Quality Improvement Initiative to Reduce Unnecessary Follow-up Imaging for Adnexal Lesions. J Am Coll Radiol 2014; 11:373-7. [DOI: 10.1016/j.jacr.2013.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 07/01/2013] [Indexed: 12/21/2022]
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Goldstein SR. Invited Commentary. Radiographics 2012. [DOI: 10.1148/radiographics.32.6.125525] [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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