Comparison of three methods for estimating volume of the uterine layers in healthy women: a stereological study / Comparación de tres métodos para estimar el volumen de las capas uterinas en mujeres sanas: un estudio estereológico

Aim of this study is to measure the volume of the uterine layers in healthy women according to the menstrual cycle phases and to test the agreement between three methods. The study was performed with 28 healthy women. Participants were divided into three groups as follicular (n=7), luteal (n=10) and postmenopausal phase (n=11). We used the point-counting and planimetry method in MR images and the ellipsoid methods in images obtained by transvaginal ultrasonography. Spearman correlation analysis showed significant negative correlations between the volumes of uterine layers and age (p<0.01). The volumes of the total uterus, the total myometrium and the endometrium measured with planimetry and point-counting methods were significantly lower in the postmenopausal women (p<0.01). While volumes of total uterus and the total myometrium significantly lower in the postmenopausal group in measurements done using ellipsoid method, the decrease in the volume of the endometrium was not statistically significant. The Bland-Altman test results indicated an excellent agreement between point-counting and planimetry methods in the volumetric measurements. The ellipsoid method might be inadequate for determining uterine layers volume particularly the endometrium volume. The stereological methods permit unbiased and efficient estimation of volume of uterine layers in vivo examination of MRI.

El objetivo de este estudio fue medir el volumen de las capas uterinas en mujeres sanas de acuerdo con las fases del ciclo menstrual y probar la concordancia de tres métodos. El estudio se realizó en 28 mujeres sanas. Las participantes se dividieron en tres grupos, folicular (n=7), luteal (n=10) y fase posmenopáusica (n=11). Utilizamos el método de conteo puntual y planimetría en imágenes de resonancia magnética y utilizamos los métodos elipsoides en imágenes obtenidas por ultrasonografía transvaginal. El análisis de correlación de Spearman mostró correlaciones negativas significativas entre los volúmenes de las capas uterinas y la edad (p <0,01). Se midieron con planimetría los volúmenes total de útero, el miometrio y endometrio, los métodos de recuento de puntos fueron significativamente más bajos en las mujeres posmenopáusicas (p <0,01). Por otra parte, el volumen total de útero y el total del miometrio fue significativamente menor en el grupo posmenopáusico en las mediciones realizadas con el método elipsoide. La disminución en el volumen del endometrio no fue estadísticamente significativa. Los resultados de las pruebas de Bland-Altman indicaron una excelente concordancia entre los métodos de recuento de puntos y de planimetría en las mediciones volumétricas. El método elipsoide puede ser inadecuado para determinar el volumen de las capas uterinas, particularmente en el volumen del endometrio. Los métodos estereológicos permiten una estimación imparcial y eficiente del volumen de las capas uterinas en el examen in vivo de la resonancia magnética.

Morphometric Evaluation of Bony Nasolacrimal Canal in a Caucasian Population with Primary Acquired Nasolacrimal Duct Obstruction: A Multidetector Computed Tomography Study

OBJECTIVE: The bony nasolacrimal duct (BNLD) morphology as a contributory factor in primary acquired nasolacrimal duct obstruction (PANDO) is still controversial. The objectives of this study were to evaluate the morphometric differences of BNLDs in unilateral PANDO patients between PANDO and non-PANDO sides, as compared with the control group using multidetector computed tomography (CT). MATERIALS AND METHODS: Bilateral BNLDs in 39 unilateral PANDO patients and 36 control subjects were retrospectively reviewed. CT images with 0.5-mm thickness were obtained with a 64-slice scanner. The length, volume, coronal orientation type, sagittal orientation angle of BNLD, and relative lacrimal sac-BNLD angle were assessed. The entrance, minimum and distal end transverse diameters (TD) of BNLD was investigated. RESULTS: The mean minimum and distal end BNLD TDs measurements were significantly narrower in PANDO patients, both in PANDO and non-PANDO sides, as compared with the control group (p < 0.001 and p = 0.040, respectively); however, there were no significant differences between PANDO and non-PANDO sides within PANDO patients. The length, entrance TD, volume, coronal orientation type, sagittal orientation angle of BNLD, and relative lacrimal sac-BNLD angle were not significantly different between PANDO patients and control subjects, as well as between PANDO and non-PANDO sides within PANDO patients. CONCLUSION: The narrow mean minimum and distal end BNLD TD in PANDO patients, in both PANDO and non-PANDO sides, may be associated with PANDO development. The lack of difference between PANDO and non-PANDO sides within PANDO patients and some overlap between PANDO patients and control subjects suggest that narrow BNLD is not the sole factor.

Rare cause of bilateral groin swelling: round ligament varicosities

Round ligament varicosity [RLV] is rare and almost all cases are pregnant women. RLV appears as a unilateral or bilateral groin swelling. Pain and tenderness may present. Clinical evaluation is inadequate for exact diagnosis because inguinal hernia has similar findings. Ultrasonography [US] is essential when a groin swelling is detected in a pregnant woman. We present gray scale US and colour Doppler US findings of a 32-week pregnant woman with bilateral RLVs at the inguinal canal, parauterine area and in the myometrium