RESUMO
OBJECTIVE: Magnetic resonance imaging (MRI) is an excellent modality for pelvic imaging. The anatomy of uterine cavity and vagina is optimally evaluated when the walls, which may spontaneously be collapsed, are distended. Distension of these cavities during pelvic MRI for evaluation of gynecologic diseases has been conducted with vagina, filled with ultrasound gel or saline solution. In this meta-analysis, we aim to assess the effectiveness of vaginal contrast media in MRI for improving the detection of pelvic pathologies. METHODS: The PubMed, MEDLINE, EMBASE, Web of Science, Google Scholar, Science Citation Index, and Cochrane Library databases were systematically searched through March 2019 for studies of the accuracy of MRI using vaginal contrast media in the diagnosis and staging of pelvic pathologies. Four eligible studies of a total of 120 patients were included in the meta-analysis. The sensitivity rates and relative risk for MRI, before and after vaginal contrast medium administration, were pooled, and their 95% confidence intervals (CIs) were determined. RESULTS: The pooled sensitivity rate for MRI before administering intravaginal contrast medium in detecting pelvic pathologies was 63% (95% CI, 54%-72%), and that after was 89% (95% CI, 83%-93%). The interstudy heterogeneity rate (assessed using the I statistic) was relatively low: 13% (P = 0.33) and 0% (P = 0.45) before and after vaginal contrast medium use, respectively. The average relative risk was 1.54 (SD, 0.22; 95% CI, 1.18-1.89; median, 1.50; range, 1.34-1.80). This demonstrated that, on average, the sensitivity rate for MRI in detecting pelvic disorders increased by 54% after the use of a vaginal contrast medium. CONCLUSIONS: Use of vaginal contrast media improved the diagnostic ability of MRI in identifying pelvic pathologies.
Assuntos
Meios de Contraste/uso terapêutico , Endometriose/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Neoplasias do Colo do Útero/diagnóstico por imagem , Vagina/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Cremes, Espumas e Géis Vaginais/uso terapêuticoRESUMO
BACKGROUND AND AIMS: Our aim was to investigate whether neurological alteration in patients with obstructive sleep apnoea syndrome (OSAS) with apparently normal cerebral and cerebellar structures can be assessed by means of apparent diffusion coefficient (ADC) measurement and to investigate the association between OSAS severity and ADC values. METHODS: Following the acquisition of diffusion-weighted cranial magnetic resonance imaging, ADC measurements were performed in 24 different apparently normal cerebral and cerebellar structures, including the bilateral frontal and parietal cortices, insulae, cingulate gyri, hippocampi, frontal and parieto-occipital periventricular white matter (PWM), caudate nuclei, putamen, thalami, cerebellar hemispheres, pons and mesencephalon in 47 OSAS patients and 20 control subjects. The ADC values of the patients and the control group were compared. The association between the apnoea-hypopnoea index (AHI) and the ADC values of the patients were investigated. RESULTS: The ADC values in the bilateral frontal PWM were lower in the patient group than those in the control subjects (P < 0.05). The measurements in the right cingulate gyri of the OSAS patients exhibited significantly higher ADC values than those of the control group (P = 0.002). Bilateral thalamic ADC values in severe OSAS patients were significantly higher than those in mild and moderate OSAS patients (P < 0.05). CONCLUSION: The ADC measurement is a simple and effective technique to evaluate neural alteration of the brain in patients with OSAS. ADC measurements can also be useful in the evaluation of the association between the AHI and the degree of neural alteration in the central nervous system.
Assuntos
Encéfalo/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Apneia Obstrutiva do Sono/diagnóstico por imagem , Adulto , Idoso , Encéfalo/patologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Estudos Prospectivos , Apneia Obstrutiva do Sono/patologiaRESUMO
PURPOSE: The human pineal gland is a small neuroendocrine organ which produces melatonin. The main goal of this study was to provide a reference range for pineal volume in all age groups and to determine calcified and noncalcified tissue and their proportions, which may be a reflection of melatonin production in all age groups, by using very thin computerized tomography (CT) slices. MATERIALS AND METHODS: A total of 167 outpatients had undergone cranial CT. Each of the subject's total pineal volume (TPV), calcified pineal volume (CPV) and noncalcified pineal volume (NPV) according to age groups were calculated in cubic millimeters. Also, proportion of calcification (POC) was noted. RESULTS: The median values were 88.5 mm3 (12.3 mm3-411mm3) for TPV, 74.3 mm3 (12.3 mm3-298 mm3) for NPV, and 3.9 mm3 (0 mm3-141 mm3) for CPV. POC showed a gradual increase from 0-49 years. In the ≥70 group, when compared with the 60-69 age group, CPV and POC values were significantly lower (P: 0.036, P: 0.034, respectively). CONCLUSION: This study brings a radiological point of view to the distribution of pineal calcification according to age that has a link with melatonin secretion.