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1.
Eur J Dermatol ; 34(2): 131-138, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38907542

ABSTRACT

The clinical diagnosis of pigmented genital lesions is challenging. Reflectance confocal microscopy (RCM) is effective for diagnosis but is limited in its application due to elevated costs. A more affordable dermatoscope with a 400x magnification (D400) has recently been brought to market. The aim of our study was to compare these two imaging techniques for the analysis of pigmented genital tumours. An observational, prospective and mono-centric study was carried out from October 2017 to May 2019, in which clinical, dermatoscopic (20x and 400x) and RCM data from 207 pigmented genital lesions were collected. The images generated via D400 and RCM were analysed by three expert investigators. Similarities between the criteria observed using D400 and RCM were evaluated by each investigator. In total, 207 lesions were included: 183 melanosis, 19 nevi, one basal cell carcinoma (BCC), two condylomas and two melanomas in situ. Our series correlates well with data found in the literature especially for the distribution of different lesions, their topography, and their aspect using x20 dermatoscopy and RCM. Pattern and cell criteria defined using RCM largely paralleled those observed with D400 for all three investigators. Correlation between D400 and RCM was moderate to strong with regards to the identification of the ring pattern and clustered round cells, strong for dendritic and plump cells, and perfect for isolated round cells and spindle cells. D400 is an easy-to-use, cost-effective alternative for the analysis of pigmented genital lesions, particularly for melanosis.


Subject(s)
Dermoscopy , Melanosis , Microscopy, Confocal , Skin Neoplasms , Humans , Microscopy, Confocal/methods , Melanosis/diagnostic imaging , Melanosis/pathology , Prospective Studies , Skin Neoplasms/pathology , Skin Neoplasms/diagnostic imaging , Female , Male , Melanoma/diagnostic imaging , Melanoma/pathology , Carcinoma, Basal Cell/diagnostic imaging , Carcinoma, Basal Cell/pathology , Middle Aged , Adult , Condylomata Acuminata/diagnostic imaging , Condylomata Acuminata/diagnosis , Condylomata Acuminata/pathology , Nevus, Pigmented/diagnostic imaging , Nevus, Pigmented/pathology , Aged , Genital Diseases, Female/diagnostic imaging , Genital Diseases, Female/pathology , Nevus/diagnostic imaging , Nevus/pathology
2.
Abdom Radiol (NY) ; 49(5): 1664-1676, 2024 05.
Article in English | MEDLINE | ID: mdl-38546827

ABSTRACT

This review aims to provide an overview of neoplastic lesions associated with genetic diseases affecting the female reproductive organs. It seeks to enhance our understanding of the radiological aspects in diagnosing genetic diseases including hereditary breast and ovarian cancer syndromes, Lynch syndrome, Peutz-Jeghers syndrome, nevoid basal cell carcinoma syndrome, and Swyer syndrome, and explores the patterns and mechanisms of inheritance that require elucidation. Additionally, we discuss the imaging characteristics of lesions occurring in other regions due to the same genetic diseases.


Subject(s)
Genetic Diseases, Inborn , Humans , Female , Genetic Diseases, Inborn/diagnostic imaging , Genital Diseases, Female/diagnostic imaging , Diagnostic Imaging/methods , Genitalia, Female/diagnostic imaging
4.
Semin Ultrasound CT MR ; 44(6): 491-500, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37832696

ABSTRACT

Acute pelvic pain is defined as a new symptom that has been present for less than 3 months. It is a common symptom seen in 15%-24% of women and is the indication for 20% of laparoscopies and 2%-10% of outpatient gynecologic visits. The pregnancy status and correlation of the physical symptoms with clinical findings are important. Ultrasound is the imaging modality of choice, not only to diagnose gynecological causes, but also bowel or urinary tract related causes of pelvic pain. When an ultrasound scan is inconclusive, a computed tomography scan is the preferred means of additional imaging and is particularly useful in gastrointestinal and urogenital causes of pelvic pain. Gynecological causes of acute pelvic pain include uterine, tubal, or ovarian pathology; non-gynecological causes include bowel diseases, such as appendicitis and diverticulitis; urogenital causes such as ureteral, bladder stones, and urinary tract infection as well as vascular causes. Ultrasound imaging alone may provide a definitive diagnosis in underlying conditions that require prompt medical or surgical intervention in gynecological conditions, such as ovarian torsion, ectopic pregnancy, and non-gynecological condition, such as in acute appendicitis.


Subject(s)
Appendicitis , Genital Diseases, Female , Pregnancy, Ectopic , Ureteral Calculi , Pregnancy , Female , Humans , Appendicitis/diagnostic imaging , Genital Diseases, Female/complications , Genital Diseases, Female/diagnostic imaging , Genital Diseases, Female/therapy , Pelvic Pain/diagnostic imaging , Pelvic Pain/etiology , Pelvic Pain/therapy , Ultrasonography
5.
Medicine (Baltimore) ; 101(43): e31329, 2022 Oct 28.
Article in English | MEDLINE | ID: mdl-36316879

ABSTRACT

BACKGROUND: The efficacy and safety of ultrasound-guided interventional procedures for gynecologic diseases have not been evaluated comprehensively. Therefore, we aimed to provide an evidence-based medical reference for clinical treatment in this meta-analysis. METHODS: The literature searches were conducted in databases of PubMed, Embase, and Web of Science for eligible studies published from 2002 to May 2022. All literature was searched, screened, and reviewed by 2 researchers separately. RevMan 5.3.0 was used to analyze the relevant data. RESULTS: A total of 12 articles consisting of 2854 patients were included. Compared with the control group, meta-analysis showed that ultrasound-guided technique in the experimental group was associated with a higher effective rate [risk ratio = 0.84, 95% confidence interval (CI) (0.84, 0.84)], a lower probability of recurrence [odds ratio = 0.13, 95% CI (0.13, 0.13), P < .00001], and a greater effective reintervention rate [odds ratio = 3.39, 95% CI (1.29, 8.86), P = .01]. However, it was not significantly associated with fewer adverse reactions. CONCLUSIONS: Ultrasound-guided technique in treating gynecologic diseases exerted a positive effect and had fewer adverse reactions, which could be popularized and applied in clinical practice.


Subject(s)
Genital Diseases, Female , Ultrasonography, Interventional , Female , Humans , Ultrasonography, Interventional/methods , Ultrasonography , Genital Diseases, Female/diagnostic imaging
7.
Comput Math Methods Med ; 2022: 4295985, 2022.
Article in English | MEDLINE | ID: mdl-35096130

ABSTRACT

OBJECTIVE: Based on resting-state functional magnetic resonance imaging (rs-fMRI), to observe the changes of brain function of bilateral uterine points stimulated by electroacupuncture, so as to provide imaging basis for acupuncture in the treatment of gynecological and reproductive diseases. METHODS: 20 healthy female subjects were selected to stimulate bilateral uterine points (EX-CA1) by electroacupuncture. FMRI data before and after acupuncture were collected. The ReHo values before and after acupuncture were compared by using the analysis method of regional homogeneity (ReHo) of the whole brain, so as to explore the regulatory effect of acupuncture intervention on brain functional activities of healthy subjects. RESULTS: Compared with before acupuncture, the ReHo values of the left precuneus lobe, left central posterior gyrus, calcarine, left lingual gyrus, and cerebellum decreased significantly after acupuncture. CONCLUSION: Electroacupuncture at bilateral uterine points can induce functional activities in brain areas such as the precuneus, cerebellum, posterior central gyrus, talform sulcus, and lingual gyrus. The neural activities in these brain areas may be related to reproductive hormone level, emotional changes, somatic sensation, and visual information. It can clarify the neural mechanism of acupuncture at uterine points in the treatment of reproductive and gynecological diseases to a certain extent.


Subject(s)
Acupuncture Points , Electroacupuncture/methods , Magnetic Resonance Imaging/methods , Uterus/diagnostic imaging , Adult , Brain/physiology , Brain Mapping , Computational Biology , Female , Functional Neuroimaging/methods , Functional Neuroimaging/statistics & numerical data , Genital Diseases, Female/diagnostic imaging , Genital Diseases, Female/physiopathology , Healthy Volunteers , Humans , Magnetic Resonance Imaging/statistics & numerical data , Uterus/physiology , Young Adult
8.
Ginekol Pol ; 93(1): 63-69, 2022.
Article in English | MEDLINE | ID: mdl-35072254

ABSTRACT

Ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) are the "gold standard" among gynecological imaging methods. They are important diagnostic tools used to determine the site of origin of a pelvic mass and to characterize the adnexal lesions. This paper summarizes the diagnostic performance of ultrasound, computed tomography, and magnetic resonance imaging in various gynecological diseases and tumours diagnostics.


Subject(s)
Genital Diseases, Female , Gynecology , Female , Humans , Tomography, X-Ray Computed , Ultrasonography/methods , Magnetic Resonance Imaging/methods , Genital Diseases, Female/diagnostic imaging
9.
Radiographics ; 41(6): E183-E184, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34597231

ABSTRACT

US-guided procedures have an essential role in the diagnosis and treatment of multiple obstetric and gynecologic conditions, can be performed with either transvaginal or transabdominal approaches, and include biopsy of masses, aspiration of fluid collections, injection of therapeutic materials, and saline-infused sonohysterography and hysterosalpingo contrast-enhanced sonography. The full digital presentation is available online. ©RSNA, 2021.


Subject(s)
Genital Diseases, Female , Biopsy , Female , Genital Diseases, Female/diagnostic imaging , Genital Diseases, Female/therapy , Humans , Pregnancy , Pregnancy Trimester, First , Ultrasonography
10.
Emerg Med Clin North Am ; 39(4): 745-767, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34600635

ABSTRACT

Abdominal pain represents 5% to 7% of all emergency department presentations. Many patients require imaging for diagnosis, and choosing the appropriate imaging modality is a crucial decision point. Modern medicine offers a fantastic array of options including abdominal radiograph, computed tomography, MRI, and ultrasonography, but the plethora of alternatives can be paralyzing. This article introduces the commonly available modalities, discusses the advantages and disadvantages, and presents current recommendations for commonly diagnosed conditions.


Subject(s)
Abdomen/diagnostic imaging , Abdominal Pain/etiology , Aortic Aneurysm/diagnostic imaging , Digestive System Diseases/diagnostic imaging , Emergency Service, Hospital , Female , Genital Diseases, Female/diagnostic imaging , Genital Diseases, Male/diagnostic imaging , Humans , Male , Mesenteric Ischemia/diagnostic imaging , Pregnancy , Pregnancy, Ectopic/diagnostic imaging
11.
Br J Radiol ; 94(1127): 20210281, 2021 Nov 01.
Article in English | MEDLINE | ID: mdl-34491817

ABSTRACT

Acute pelvic pain (APP) requires urgent medical evaluation and treatment. Differential diagnosis of APP is broad, including a variety of gynecologic and non-gynecologic/ urinary, gastrointestinal, vascular and other entities. Close anatomical and physiological relations of pelvic structures, together with similar clinical presentation of different disorders and overlapping of symptoms, especially in the emergency background, make the proper diagnosis of APP challenging. Imaging plays a crucial role in the fast and precise diagnosis of APP. Ultrasonography is the first-line imaging modality, often accompanied by CT, while MRI is utilized in specific cases, using short, tailored protocols. Recognizing the cause of APP in females is a challenging task, due to the wide spectrum of possible origin and overlap of their imaging features. Therefore, the radiologist has to be familiar with the possible causes of APP, and, relying on clinical presentation, together with laboratory findings, choose the best imaging strategy in order to establish a fast and accurate diagnosis.


Subject(s)
Diagnostic Imaging/methods , Gastrointestinal Diseases/complications , Genital Diseases, Female/complications , Pelvic Pain/etiology , Urologic Diseases/complications , Vascular Diseases/complications , Acute Pain/etiology , Female , Gastrointestinal Diseases/diagnostic imaging , Genital Diseases, Female/diagnostic imaging , Humans , Male , Urologic Diseases/diagnostic imaging , Vascular Diseases/diagnostic imaging
12.
Emerg Med Clin North Am ; 39(3): 509-527, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34215400

ABSTRACT

Point-of-care ultrasound has become an essential part of pediatric emergency medicine training and practice. It can have significant clinical benefits, including improving diagnostic accuracy and decreasing length of stay, and does not require radiation exposure for patients. In this review, we summarize the current diagnostic point-of-care ultrasound applications in pediatric emergency medicine, their evidence, and techniques.


Subject(s)
Pediatric Emergency Medicine , Point-of-Care Systems , Ultrasonography , Biliary Tract Diseases/diagnostic imaging , Child , Eye Diseases/diagnostic imaging , Female , Focused Assessment with Sonography for Trauma , Gallbladder Diseases/diagnostic imaging , Gastrointestinal Diseases/diagnostic imaging , Genital Diseases, Female/diagnostic imaging , Heart Diseases/diagnostic imaging , Humans , Kidney Diseases/diagnostic imaging , Lung Diseases/diagnostic imaging , Male , Pregnancy , Spermatic Cord Torsion/diagnostic imaging , Urinary Bladder Diseases/diagnostic imaging , Vena Cava, Inferior/diagnostic imaging
13.
Australas J Dermatol ; 62(3): 360-363, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34028797

ABSTRACT

Hidradenitis Suppurativa is a chronic inflammatory disease manifesting in painful nodules, abscesses and malodorous draining tunnels with a pre-disposition to flexural regions of skin. Traditional surgical interventions include excision of clinically visible lesions and in severe cases - excision down to fascia of entire anatomical regions (axilla, groin) and repair with split-thickness grafting or skin substitutes. However, such techniques are plagued by long healing times (up to several months), extensive tissue loss and high recurrence rates given that a large proportion of disease is not clinically visible. Deroofing is a tissue-saving surgical technique, ideal for Hurley Stage 2 disease, which when combined with bedside pre-operative sonography can allow for the accurate identification and removal of occult dermal tunnels whilst minimising the risks of pain, infection, minimising healing times and can be safely conducted in the setting of immunomodulatory therapy.


Subject(s)
Hidradenitis Suppurativa/diagnostic imaging , Hidradenitis Suppurativa/surgery , Ultrasonography, Interventional/methods , Female , Follow-Up Studies , Genital Diseases, Female/diagnostic imaging , Genital Diseases, Female/surgery , Genital Diseases, Male/diagnostic imaging , Genital Diseases, Male/surgery , Humans , Male , Re-Epithelialization
14.
Abdom Radiol (NY) ; 46(9): 4420-4431, 2021 09.
Article in English | MEDLINE | ID: mdl-33890122

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.


Subject(s)
Appendicitis , Genital Diseases, Female , Female , Genital Diseases, Female/diagnostic imaging , Genitalia, Female/diagnostic imaging , Humans , Multidetector Computed Tomography , Pelvis
15.
Semin Ultrasound CT MR ; 42(1): 104-112, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33541584

ABSTRACT

Interventional radiology is continuing to reshape current practice in many specialties of clinical care and the fields of gynecology and obstetrics are no exception. Imaging skills, clinical knowledge as well as vascular and non-vascular interventional technical ability, are essential to practice interventional radiology effectively. Patient safety is of paramount importance in interventional radiology as in all branches of medicine. Potential failures occur throughout successful procedures and are attributed to a spectrum of errors, including equipment unavailability, planning errors, and communication errors. These are mainly preventable by improved preprocedural planning and teamwork. Of all the targeted and effective actions that can be undertaken to reduce adverse events, the use of safety checklists might have a prominent role. The advantage of a safety checklist for interventional radiology is that it guarantees that human error in terms of forgetting key steps in patient preparation, intraprocedural care, and postoperative care are not forgotten.


Subject(s)
Genital Diseases, Female/diagnostic imaging , Genital Diseases, Female/therapy , Gynecology/methods , Obstetrics/methods , Patient Safety , Radiography, Interventional/methods , Radiology, Interventional/methods , Female , Humans , Pregnancy
18.
Comput Math Methods Med ; 2021: 9508838, 2021.
Article in English | MEDLINE | ID: mdl-35003327

ABSTRACT

In order to explore the effective diagnosis method of gynecological acute abdomen, this paper takes hospital gynecological acute abdomen patients as samples and selects gynecological acute abdomen patients admitted to the hospital to be included in this study. They are divided into transabdominal ultrasound group, intracavitary ultrasound group, and combined group. Moreover, this paper uses mathematical statistics to carry out sample statistics. The statistical data mainly include ectopic pregnancy, torsion of ovarian tumor pedicle, acute suppurative salpingitis, torsion of fallopian tube, hemorrhagic salpingitis, acute pelvic inflammatory disease, rupture of corpus luteum cyst, and diagnosis accuracy rate. In addition, this paper compares the diagnostic accuracy of the abdominal ultrasound group, the intracavitary ultrasound group, and the combined group. The experimental research shows that the combined ultrasound diagnosis method can effectively improve the accuracy of the diagnosis of gynecological acute abdomen.


Subject(s)
Abdomen, Acute/diagnostic imaging , Genital Diseases, Female/diagnostic imaging , Ultrasonography/methods , Abdomen, Acute/complications , Computational Biology , Diagnosis, Differential , Female , Humans , Pregnancy , Pregnancy Complications/diagnostic imaging , Pregnancy, Ectopic/diagnostic imaging , Ultrasonography/statistics & numerical data
19.
BMC Med Imaging ; 20(1): 121, 2020 10 27.
Article in English | MEDLINE | ID: mdl-33109134

ABSTRACT

BACKGROUND: Point-of-care ultrasound (POC-US) is a diagnostic test conducted at the site of patient care with direct interpretation by the clinician, providing immediate results. POC-US for gynecologic application is not well characterized by current literature yet has the potential to increase access in limited resource settings. We compared the diagnostics of three POC-US devices for gynecologic (GYN) pathology and then performed evaluation of sensitivity and specificity of a single best POC-US device for intended use in a low resource setting. METHODS: This is prospective, pilot descriptive study of 60 subjects. In part 1, comparison of three POC-US devices was performed. Twenty subjects underwent POC-US with three test units [GE Vscan (Vscan), Sonosite Iviz (Iviz), Philips Lumify (Lumify)] followed by diagnostic ultrasound (Dx-US) for reference imaging. Image quality and correlation for devices was scored by blinded reviewers and quantitative measurements of GYN pathology were compared. In part 2, forty subjects underwent POC-US validation with the highest scoring device (Lumify) and Dx-US for reference imaging. Concordance of POC-US operator-interpreted diagnosis with reference imaging interpretation were assessed by Cohen's unweighted kappa coefficient. Accuracy and agreement of POC-US were assessed by linear regression and Bland-Altman plot analysis. Sensitivity and specificity of POC-US for gynecologic pathologies were calculated. RESULTS: In aggregate qualitative measurements, Lumify and Iviz units performed superiorly to Vscan. There was no statistically significant difference in quantitative measurements between devices, but a trend towards lower mean error was seen for Lumify and Iviz as compared to Vscan. Lumify device had highest overall scoring and was selected for further testing. In validation comparison of Lumify to Dx-US, no statistically significant differences were found for measurements of endometrium, uterus, ovaries, adnexal pathology, or leiomyomata, (P < 0.02) with excellent agreement in operator-interpreted diagnosis (Kappa > 0.7). Sensitivity and specificity of detecting pathology was 80-100% with PPV and NPV 76-100%. CONCLUSION: Among three POC-US devices, Lumify and Iviz devices show highest potential for successful application to clinical gynecologic ultrasound. Clinician-performed POC-US has high diagnostic accuracy, sensitivity, and specificity for basic GYN anatomy and pathology. POC-US is an acceptable and feasible diagnostic tool with potential for future application in a low resource setting to increase access to ultrasound.


Subject(s)
Genital Diseases, Female/diagnostic imaging , Genital Diseases, Female/pathology , Ultrasonography/instrumentation , Adult , Feasibility Studies , Female , Humans , Linear Models , Middle Aged , Observer Variation , Pilot Projects , Point-of-Care Testing , Prospective Studies , Sensitivity and Specificity , Socioeconomic Factors
20.
J Clin Ultrasound ; 48(8): 457-461, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32691423

ABSTRACT

PURPOSE: Point-of-care ultrasound (POCUS) is gaining recognition as a teaching modality that acts as an integrative learning tool during medical student transition to clinical rotations. This study aimed to determine if the use of ultrasound simulation enhances understanding of Obstetrical and Gynecological (Ob/Gyn) anatomy and pathology in third-year medical students (M3), and if M3 students found the simulator useful. METHODS: M3 students taking the OB/Gyn clerkship were invited to participate. Baseline knowledge of pelvic ultrasound anatomy and pathology was assessed with a multiple-choice question test. Participants received a one-hour OB/Gyn ultrasound simulation training session. A post-test assessed knowledge after the intervention. Survey data was collected regarding learning styles and learner satisfaction. RESULTS: Following simulator-based training, the median correct number of responses to the knowledge questions increased from 11 of 18 to 14 of 18 correct (P < .001). Statistically significant increases were also observed in comfort level with OB/GYN ultrasound (P < .001). All 68 students answered that the ultrasound simulator was helpful and enjoyed using the simulator. CONCLUSIONS: This study suggests that ultrasound simulators are useful for improvement in knowledge, comfort level, and ability to identify pathology in Ob/Gyn scenarios in M3 students.


Subject(s)
Genitalia, Female/diagnostic imaging , Gynecology/education , Obstetrics/education , Simulation Training/methods , Education, Medical/methods , Female , Genital Diseases, Female/diagnosis , Genital Diseases, Female/diagnostic imaging , Genital Diseases, Female/pathology , Genitalia, Female/anatomy & histology , Humans , Learning , Male , Manikins , Students, Medical , Surveys and Questionnaires , Ultrasonography
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