Efficacy and safety of iopromideas a contrast agent in gynecological pelvic CT examination / 中国辐射卫生

Objective To investigate the efficacy and safety of iopromide as a contrast agent in gynecological pelvic CT examination. Methods In a retrospective study, 78 patients hospitalized from February 2018 to January 2021 who underwent contrast-enhanced gynecological pelvic CT were involved to investigate the image quality, systemic and local tolerance, and adverse reactions. Results Among the 78 cases, 97.44% had excellent image quality and 97.44% showed tolerance. Mild adverse reactions such as nausea and vomiting, dizziness, headache, local pain, and facial flushing occurred in 8.98% cases. Moderate adverse reactions included severe vomiting with generalized rash (one case) and chest tightness and shortness of breath with generalized rash (one case), and both patients returned to normal after treatment. Conclusion The non-ionic contrast agent iopromide can be used to obtain good image quality in gynecological pelvic CT examination. The incidence of adverse reactions of iopromide is lower than ionic iodine contrast agents, but higher other non-ionic contrast agents.

Androgen Insensitivity Syndrome with Bilateral Cryptorchidism and Seminoma in Tibet:Report of One Case / 中国医学科学院学报

Androgen insensitivity syndrome(AIS)with bilateral testicular malignant transformation is very rare,and its diagnosis should be based on clinical manifestations,physical examination,serological findings,karyotype analysis,and pathological findings.This study reported a case of complete androgen insensitivity syndrome among Tibetan in Tibet.It took 17 years from the discovery of congenital absence of uterus to bilateral pelvic mass resection.Pathological examination confirmed that bilateral pelvic space occupying lesions were dysplastic testicular tissue with seminoma and sertoli cell adenoma-like nodules.This study summarized the clinicopathological features to deepen the understanding of the disease.

Chinese expert consensus on standardized treatment of presacral cysts / 中华肿瘤杂志

Presacral cysts are cystic or cyst-solid lesions between the sacrum and rectum. They are closely connected with adjacent pelvic floor structures such as sacrococcygeal fascia, rectum and anal sphincter. They are usually benign and are believed to be caused by aberrant embryogenesis. Clinically they are rare and its true incidence rate is unknown. Surgical resection remains the major treatment of presacral cysts. Unless the cysts are completely resected, the recurrence are unavoidable. The recurrent cysts even generate hard-to-heal sinus in the sacrococcyx, and cause the patients extreme pain. However, the current knowledge of presacral cysts is vague, even confused with other diseases such as ovarian cysts and perianal abscesses. Moreover, lack of the correct surgical concept or skills leads to palliative treatment of complex presacral cysts and serious complications such as fecal incontinence and massive haemorrhage which were attributed to impairing the function of anal sphincter or important blood vessels and nerves. The consensus summarizes the opinions and experiences of multidisciplinary experts in presacral cysts, and aims to provide clinicians with more detailed concept of the treatment, standardize the surgical approach and improve the resected efficacy of presacral cysts.

Advances in bowel delineation and dose-volume constraint in intensity modulated radiation therapy and 3D conformal radiation therapy for pelvic tumors / 中华放射医学与防护杂志

Intestinal injury is an important toxic response during radiation therapy of pelvic tumors. With the widespread use of precision radiotherapy techniques such as intensity modulated radiation therapy (IMRT), the dose exposed to normal tissues and organs has been significantly reduced. However, the toxic response of the bowel still limits the increase of the dose to the target volume. Therefore, the protection of important organs at risk (OAR), such as the bowel, becomes more and more important while giving adequate irradiated dose to the target volume. Most current studies used loop to contour bowel. For patients who underwent IMRT, the meaningful dose-volume predictors of grade 2 acute intestinal adverse events using bowel loop (small loop + big bowel) delineation included V45 Gy < 50 cm 3,V50 Gy < 13 cm 3, and V55 Gy < 3 cm 3, and the corresponding predicators using bowel bag delineation were V40 Gy < 170 cm 3,V45 Gy < 100 cm 3, and V50 Gy < 33 cm 3.

Clinical Characteristics of Recurrent Endometrial Carcinoma: Report of 22 Cases / 中国微创外科杂志

Objective To summarize the clinical characteristics of recurrent endometrial carcinoma.Methods A total of 22 cases of recurrent endometrial carcinoma from January 2006 to December 2015 were enrolled.Primary diagnosis of endometrial carcinoma were made in our hospital,with complete clinical data and standard NCCN staging operation.The recurrence of endometrial cancer was confirmed by pathological diagnosis after second surgery or biopsy.Clinical data were retrospectively analyzed.Results The median age of primary diagnosis was 52 years old (rang,44-63 years old).And the most common clinical symptom was postmenopausal vaginal bleeding (54.5％,12/22).There were 18 cases (81.8％) of endometrial adenocarcinoma,3 cases (13.6％) of serous adenocarcinoma,and 1 case (4.5％) of clear cell carcinoma.As to the muscular layer infiltration,there were 14 cases (63.6％) ＜ 1/2,7 cases (31.8％) ＞ 1/2 and 1 case (4.5％) involving the whole layer.There were 4 cases (18.2％) of positive pelvic lymph node and no para-aortic lymph nodes metastasis.As to the postoperative clinical pathologic stage,there were 12 cases (54.5％) of FIGO Ⅰ A,5 cases (22.7％) of FIGO Ⅰ B,1 case (4.5％) of FIGO Ⅱ,and4 cases (18.2％) of FIGO ⅢC1.The median recurrent time was 4 years (rang,1.5-7 years),without obvious self-conscious symptoms,including serum CA125 elevated in 12 cases (54.5％) and positive ultrasound,CT or X-ray examination findings in 10 cases (45.5％).As to the recurrence location,14 cases (63.6％) were in the pelvic cavity,6 cases (27.3％) of retroperitoneal lymph nodes,1 case (4.5％) of anterior abdominal wall accompaning lung metastasis,and 1 case (4.5％) of lung metastasis.Three patients accept Lynch syndrome screening,of which 2 cases were positive.Conclusions Muscular layer infiltration is common in recurrence of endometrial cancer,with no obvious clinical symptoms.Pelvic cavity is the most common location of recurrence.

Perioperative nursing care to 8 patients with for pelvic cavity and genital tract aggressive angiomyxoma / 现代临床护理

Objective To summarize the experience in perioperatively nursing 8 patients with pelvic cavity and genital tract aggressive angiomyxoma (AAM). Method The perioperative nursing care was given to 8 AAM patients who were hospitalized in the department of obstetrics and gynecology from January 2010 to June 2015. Results The abdominal and perineal wounds were healed well without complications. All patients were recovered and discharged. One case had a relapse 2 years and another did 3 years after operation. Conclusion Such nursing measures as preoperative psychological nursing, close observation of the disease conditions, nursing cooperation during rescue for postoperative bleeding, treatment of postoperative complications and enhancing health education concerning the importance of long-term follow-up can be helpful for their recovery.

Diagnostic Value of Contrast-enhanced Ultrasonography in Differentiating Benign and Malignant Tumor of Pelvic Cavity / 昆明医科大学学报

Objective To discuss the diagnostic value of contrast-enhanced ultrasonography in differentiating benign and malignant tumor of pelvic cavity.Methods From October 2014 to January 2016,abdominal ultrasonography or trans-vaginal ultrasonography were performed among outpatients and inpatients in the First Affiliated Hospital of Kunming Medical University.We found 62 cases with pelvic cavity tumors with 64 lumps,which were detected at cystic mass,cystic-solid mass,and solid mass in conventional ultrasonography.We made the diagnosis of all the lumps by performing contrast-enhanced ultrasonography,observing the infusion process and analyzing perfusion pattern,the intensity of perfusion and time intensity curve.By contrasting the diagnosis and the pathologic and long-term follow-up results,we classified the tumors into two groups,benign and malignant.Then we analyzed the time intensity curve and imaging parameters of the two groups.Restlts Among the total 64 lumps,43 was found in the group of benign tumor and 21 in the group of malignant tumor.Sixty-two were proved by pathologic results and 2 were proved by long-term follow-up results.Benign tumors showed that the infusion flowed from the peripheral to the center and enhanced equably and the vessels were regularly shaped.Malignant tumor showed that the infusion infiltrated from the center to the peripheral and enhanced quickly and unequally,and vessels were distorted.In the time intensity curve,group of benign tumors presented a gently slow raise and fall type,and group of malignant tumors showed a quickly raise and fall type.Rise time (RT) of malignant group (7.70 ± 2.56s) was shorter than benign group (11.40 ± 6.77s) (P＜0.05).Peak intensity (PI) of malignant group (16.30 ± 7.41dB) was higher than benign group (12.12 ± 6.70dB) (P＜0.05).Area Under the Curve (AUC) of malignant group (981.65 ± 548.04 dB s) was bigger than benign group (715.22 ± 651.04dB s) (P＜ 0.05).No difference was found between two groups in Time to Peak (TP) and Mean Transit Time (MTF) (P＞ 0.05).The sensitivity,specificity,positive and negative predictive value of contrast-enhanced ultrasonography were 95.2％,93.0％,86.9％,and 97.5％ respectively.Conclusion Contrast-enhanced ultrasonography ean show an eligible blood perfusion and vascularity of lumps.Analyzing perfusion pattern,time intensity curve,and other parameters can improve capacity of diagnosing and differentiating benign tumor and malignant tumor of pelvic cavity.

Differentiation between tuberculosis and leukemia in abdominal and pelvic lymph nodes: evaluation with contrast-enhanced multidetector computed tomography

PURPOSE: To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT). MATERIALS AND METHODS: We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52%) or leukemia (51 patients; 48%). In patients with leukemia, 32 (62.7%) had chronic lymphocytic leukemia, and 19 (37.3%) had acute leukemias; of these, 10 (19.6%) had acute myeloid leukemia, and 9 (17.6%) had acute lymphocytic leukemia. RESULTS: The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia) and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia) lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p <0.017). Tuberculosis showed peripheral enhancement, frequently with a multilocular appearance, in 43 (78.2%) patients, whereas patients with leukemia (78.9% for acute myeloid leukemia and acute lymphocytic leukemia, 87.5% for chronic lymphocytic leukemia) demonstrated predominantly homogeneous enhancement (both with p <0.017). For the diagnosis of tuberculosis, the analysis showed that a peripheral enhancement pattern had a sensitivity of 78.2%, a specificity of 100%, and an accuracy of 88.7%. For the diagnosis of leukemia, the analysis showed that a homogeneous enhancement pattern was associated with a sensitivity of 84.3%, a specificity of 94.5%, and an accuracy of 89.6%. CONCLUSION: Our findings indicate that the anatomical distribution and enhancement patterns of lymphadenopathy seen on multidetector computed tomography are useful for differentiating between untreated tuberculosis and leukemia of the abdominopelvic lymph nodes. .

MRI diagnosis of pelvic endometriosis outside the ovary / 实用放射学杂志

Objective To explore the MRI features of pelvic endometriosis outside the ovary.Methods 13 patients with pelvic endometriosis outside the ovary were imaged.Their clinical and imaging data were reviewed retrospectively.All cases were con-firmed by pathology.An enhanced MR using T1 WI sequence both in sagittal and transverse position was performed after T2 WI fat-suppression sequence and T1 WI sequence.Our MRI study was focused on the distribution of lesions locating in the deep pelvic cavity and abdominal wall,and the features of MRI signals .Results 13 lesions were found,in which 4 lesions located in the rectouterine pouch of Douglas,2 cases the bladder wall,2 cases the unilateral cystic inlet of ureter,1 case the anal canal wall,and 4 cases the ab-dominal wall.10(10/13)lesions were shown as solid nodules while 3(3/13)lesions as cyst-solid ones.All lesions showed moderate-ly heterogeneous enhancement.Conclusion Pelvic endometriosis outside the ovary mainly shows solid or cyst-solid lesions that lo-cates in the urinary,uterus,rectal wall and spaces around them.MR images show a higher value for the detection of the lesions out-side the ovary.

Pilot application of statistical iterative reconstruction and automatic tube current modulation in adult low-dose pelvic CT / 中华放射医学与防护杂志

Objective To investigate the feasibility of reducing the radiation dose in adult pelvic CT using automatic tube current modulation (ATCM) and adaptive statistical iterative reconstruction (ASIR).Methods Totally 45 patients who underwent routine and low-dose pelvic CT examination were enrolled in our study.Three groups of images were acquired:group A (routine scan with FBP reconstruction) ;group B1 (low-dose with ASIR0) and group B2 (low-dose with ASIR50％).The scores of image quality was abtained by two radiologists.Results The CTDIvol,DLP and E of group B were significantly reduced respectively(t =12.30,12.10,12.15,P ＜ 0.05) compared with group A.Group B1 had higher noise(t =9.14,8.95,P ＜ 0.05)and lower score,SNR and CNR(t =8.72,10.62,11.83 and 8.40,9.55,11.42,P ＜ 0.05) than the others.And there was no difference in image quality between group A and group B2.Conclusions Using automatic tube current modulation and adaptive statistical iterative reconstruction could significantly reduce the noise but keep the image quality in adult pelvic CT examination.

Effect of the pathological changes of the pelvic cavity and fallopian tube on the outcome of in vitro fertilization and embryo transfer / 中国医师进修杂志

Objective To evaluate the effect of the pathological changes of the pelvic cavity and fallopian tube on the outcome of in vitro fertilization and embryo transfer(IVF-ET).Method One thousand and thirty-two patients who underwent IVF-ET were divided into tubal and pelvic infertile group(605 cases)and non-tubal and pelvic infertile group(427 cases).The tubal and pelvic infertile group was also divided into salpingemphraxis group(243 cases),tubal resection group(104 cases),fallostomy group(149 cases),tubal dropsy group(109 cages)according to the tubal lesion regions,and combined with pelvic group(194 cases),combined without pelvic group(411 cases).The data of clinical pregnancy,ectopic pregnancy,and abortion was analyzed respectively.Results The ectopic pregnancy and abortion rates in tubal and pelvic infertile group[10.63%(27/254)and 9.06%(23/254)]were higher than those in non-tubal and pelvic infertile group [3.27%(5/153)and 4.58%(7/153)](P<0.01 or<0.05).The ectopic pregnancy rate was the lowest in tubal resection group[2.17%(1/46)],the highest in fallostomy group[22.41%(13/58)],there was significant difference among the groups(P<0.01).The abortion rate in fallostomy group and tubal dropsy group[10.34%(6/58)and 15.00%(6/40)]was higher than that in salpingemphraxis group and tubal resection group [7.27%(8/110)and 6.52%(3/46)],there was significant difference among the groups(P<0.05).The abortion rate in combined with pelvic group[11.54%(9/78)]was higher than that in combined without pelvic group[7.95%(14/176)](P<0.05).Conclusions The pathological changes of the pelvic cavity and fallopian tube are higher risk factors of ectopic pregnancy and abortion occurrence.The assessment and treatment of pelvic cavity and fallopian tube before assisted reproductive treatment cycles should be enhanced.

A Case of an Extragastrointestinal Stromal Tumor of the Pelvic Cavity Presenting with Hematuria / 대한내과학회지

Although gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract, it also occurs in the non-gastrointestinal tract, and is referred to as extragastrointestinal stromal tumor (EGIST). In this report, we describe a 48-year-old female patient who presented with hematuria, and who was finally diagnosed with a primary extragastrointestinal stromal tumor of the pelvic cavity involving the bladder, vagina and left ureter. Tumor cells were positive for immunohistochemical staining for CD117 antigen (proto-oncogene protein c-kit), CD34, and vimentin, whereas they were negative for desmin, smooth muscle actin, and S-100 protein. These findings provide histopathological and immunohistochemical evidence for diagnosing this tumor as EGIST.

Ganglioneuroma in Pelvic Cavity / 대한비뇨기과학회지

Ganglioneuroma is a rare benign tumor which originates in the neural crest, and is found along the path of the sympathetic chain, from the base of the skull to the pelvic cavity. Due to the slow growth of this type of tumor, it may be detected incidentally, or detected by virtue of the attendant pressure effects on adjacent structures. We report one case of ganglioneuroma arising in the pelvic cavity.

A case of malignant peripheral nerve sheath tumor of pelvic cavity / 대한산부인과학회지

A 75-year-old female presented with a 1-month history of low abd pain. A 15 x 13 cm solid mass was noted in pelvic cavity by imaging study. The patient underwent an exploratory laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymph node dissection and omentectomy. Immunohistochemistry aided in the final diagnosis of a malignant peripheral nerve sheath tumor. The patient had several poor prognosis factor and relapsed into tumor and died 5 month after surgery. An extremely rare case of malignant peripheral nerve sheath tumor of pelvic cavity is reported with a brief review of the literature.

A Case of Mesenteric Panniculitis in Pelvic Cavity / 대한산부인과학회지

Mesenteric panniculitis is a infrequent, benign idiopathic inflammatory disease of the mesenteric fat tissues. It is characterized by infiltration of lipid-laden macrophages and associated with variable degree of inflammation and fibrosis. Common symptoms are abdominal pain and palpable mass. The diagnosis is made by ultrasound, computed tomogram (CT), magnetic resonance imaging (MRI), combined with the histologic findings. However, definitive diagnosis is difficult in many cases and it is often misdiagnosed as abdominal tumor before laparotomy is performed. Because mesenteric panniculitis can occur in pelvic cavity, it should be differentiated from tumor of pelvic organ. We report a case of mesenteric panniculitis of rectosigmoid colon mimicking pelvic tumor with a brief review of literatures.

A Case of Infected Huge Lymphangioma in Pelvic cavity / 영남의대학술지

Lymphangioma is a benign tumor resulted from abnormal communication between large dermal lymphatic channels and central lymphatic system. The tumor is encountered more often in the neck and axilla and less often in mediastinum, omentum, retroperitoneum, and scrotum. It rarely developed at urogenital system, and there has been no previous description of lymphangioma involving the bladder wall in Korea. We report a case of 35-year-old female with infected huge lymphagioma arising from pelvic cavity and involving bladder wall.

A Case of Infected Huge Lymphangioma in Pelvic cavity / 영남의대학술지

Lymphangioma is a benign tumor resulted from abnormal communication between large dermal lymphatic channels and central lymphatic system. The tumor is encountered more often in the neck and axilla and less often in mediastinum, omentum, retroperitoneum, and scrotum. It rarely developed at urogenital system, and there has been no previous description of lymphangioma involving the bladder wall in Korea. We report a case of 35-year-old female with infected huge lymphagioma arising from pelvic cavity and involving bladder wall.

A Case of Localized fibrous tumor of Pelvic Cavity / 대한비뇨기과학회지

Localized fibrous tumor is an uncommon submesothelial origin tumor found in pleura most commonly. Sixty five-year-old man with right lower quadrant pain was admitted. He was treated with resection of tumor and was diagnosed as localized fibrous tumor of pelvic cavity. He is now being followed up without any evidence of recurrence for 34 months. This case is presented with reviewing references.

A Case of Pulmonary Carcinosarcoma which Metastasize to Pelvic Cavity After Left Pneumonectomy / 결핵

Pulmonary carcinosarcoma(Sarcomatoid carcinoma of the lung) is a rare pulmonary malignancy, which is defined as having an admixtture of both carcinomatous and sarcomatous components. Pulmonary carcinosarcoma occurs most frequentlly in males between 50 and 80 years of age. It predominantly affects the upper lobe and/or the principal bronchi, and is associated with a history of smoking. Here, we report a case of pulmonary carcinosarcoma with a left lobe atelectasis due to an endobronchial mass in a 56-year-old male. After a left pneumonectomy, the pathologic stage was IIb (T3N0M0). Four months later, an abdominal mass was observed and exploratory laparotomy revealed metastases of the pulmonary carcinosarcoma to the pelvic cavity.

A Case of Ganglioneuroma in the Pelvic Cavity / 대한비뇨기과학회지

We present a case of ganglioneuroma arsing from the sympathetic ganglia in the pelvic cavity.