Pelvic Endometriosis: Spectrum of Magnetic Resonance Imaging Findings.

Endometriosis is defined as the presence of endometrial tissue outside the uterus. It is a common cause of pelvic pain and infertility among reproductive age women. Although laparoscopy remains the reference standard for diagnosis, this invasive procedure provides little information on subperitoneal extent of disease or areas hidden by adhesions. In contrast, magnetic resonance imaging (MRI) provides a comprehensive, noninvasive survey of the pelvis with simultaneous tissue characterization. In this article, we review the spectrum of MRI findings in pelvic endometriosis and discuss common complications associated with the disease. Radiologists should be familiar with the spectrum of MRI findings of pelvic endometriosis so that they can provide meaningful information that will guide treatment and future laparoscopic examinations.

Multiplex real-time PCR for the detection and quantitation of HTLV-1 and HTLV-2 proviral load: addressing the issue of indeterminate HTLV results.

BACKGROUND: Routine diagnosis of Human T Lymphotropic virus (HTLV) infection is primarily serologically based; however the proportion of unresolved and indeterminate Western blot results range from 0.02% to 50% in endemic areas. OBJECTIVES: To validate a sensitive in-house quantitative multiplex real-time assay (mqRT-PCR), capable of detecting and quantifying HTLV-1 and HTLV-2, and use it to differentiate unresolved serological profiles, and monitor infection in HTLV-1 infected patients. STUDY DESIGN: The mqRT-PCR was designed as a single-tube assay. Quantitative results were reported as copy number of HTLV provirus per 10(6) cells and the numbers of cells were calculated based on the quantitative result for albumin, of which there are 2 copies/cell. Assay standards were amplified from HTLV-1 infected MT-2 cells and HTLV-2 transfected CEM cells. Blood samples were obtained from HTLV seropositive former blood donors. RESULTS: The mqRT-PCR assay was efficient (98.8-101.2%), reproducible (coefficient of variance<5%) and sensitive to 1 copy for HTLV-1, HTLV-2 and Albumin. The assay resolved the infection profile in 16/17 patients, with undetermined subtype, all of which were reassigned as HTLV-1 infections. In addition, the average PVL detected in patients suffering from HTLV-1 associated HAM/TSP (n=23, 13,450 copies/10(6) cells) was significantly higher than those detected in asymptomatic carriers (n=21, 6665 copies/10(6) cells). CONCLUSIONS: We propose a new testing algorithm for the laboratory diagnosis of HTLV infection, which includes HTLV specific mqRT-PCR for resolving HTLV serological results. Furthermore, quantitation of PVL load by real-time PCR may be useful in assessing the link between infection and disease, and in monitoring patients undergoing therapy.