A simplified approach to ovarian lesions based on the O-RADS US risk stratification and management system

Compared to the risk-oriented approach to ovarian lesions that is presented in the Ovarian- Adnexal Reporting and Data System (O-RADS) US Risk Stratification and Management System as a guideline, a lesion-oriented flowchart is more user-friendly for radiologists. In the present article, the O-RADS guideline has been depicted in the form of a single flowchart to explain how to approach ovarian lesions in an algorithmic manner. In addition to providing a practical flowchart, this pictorial article contains some images of the related ovarian lesions.

Successful local and systemic medical treatment of cesarean scar pregnancy and a subsequent term pregnancy after treatment: a case series

Treatment of cesarean scar pregnancy [CSP] is controversial. The objective of this study was to report our successful experience in the medical treatment of CSP with potassium chloride [KCl] and methotrexate. Case: This is a case series of six patients between 6-12 gestational weeks with the diagnosis of CSP. In five cases the fetus was alive and in one case, despite being at a gestational age of 12 weeks based on CRL, there was no fetal heart activity. In four of these cases, an ultrasound- guided KCl injection in the heart was performed on four living fetuses and then systemic methotrexate was administered. In two other cases, methotrexate was injected into the gestational sac and subsequently the systemic methotrexate was administered. During follow-up, the patients were stable and no complications occurred. Additionally, serum beta human chorionic gonadotropin [Beta-NCG] was negative between five to 11 weeks later. One of the patients became pregnant one year later. Her pregnancy continued without any complication and she was delivered by cesarean section at the gestational age of 38 weeks. During caesarean section, it was noticed that the appearance of previous cesarean scar was normal and there was no scar. Based on our experience, the combination of systemic Methotrexate with local Methotrexate or KCl is feasible and can be performed as an outpatient procedure and is successful in the treatment of CSP

Association of reproductive and menstrual characteristics with mammographic density

Background: Mammographic density has been recognized as a risk factor for breast cancer, but the association between potential effective factors and mammographic density has not been fully studied in Asian women. We conducted a study to investigate the association of mammographic breast density with several menstrual and reproductive characteristics. Methods: Screening mammography was performed in women above 40 years attending the breast clinic of Arash Women's Hospital, Tehran, Iran, for breast cancer screening. The densities were classified by two expert radiologists according to the parenchymal mammographic classification system of the American College of Radiologists. Those with a history of breast cancer or renal disease, recent hormone replacement therapy, or consumption of vitamin D supplements were excluded. Results: Overall, 823 patients were assessed. Mammographic density was associated with higher age at first birth [P < 0.001], lower parity [P < 0.001], BMI [P < 0.001], and premenopausal status [P < 0.001]. However, no associations were observed with age at menarche [P = 0.057] and menstrual pattern [P = 0.973]. Conclusions: Our study showed an association between mammographic density and age, parity, BMI, and age at first birth, and no association with menstrual pattern in terms of regularity and age at menarche. In addition, mammographic density was significantly higher in premenopausal women