Subject(s)
Internship and Residency , Radiology , Humans , Radiology/education , Radiography , ForecastingABSTRACT
The purpose of this study was to assess the role of magnetic resonance venography (MRV) with time-resolved imaging of contrast kinetics (TRICKS) in dynamically evaluating ovarian vein dilation, reflux and direction of flow in patients with suspected pelvic congestion syndrome (PCS). The hypotheses tested were: (i) That conspicuity scores of the ovarian veins across three raters was greater using TRICKS MRV compared with T2W or T(2)* imaging; (ii) That three key MR variables (ovarian vein diameter, timing and grade of reflux) correlated across all raters. We carried out a retrospective study of 13 patients undergoing T2W and TRICKS MRI and pelvic sonography (n = 4) or catheter venography (n = 5). Three observers rated conspicuity, vessel diameter, timing and grade of ovarian vein reflux for T(2)/T2*W and TRICKS MRI. The mean left ovarian diameter for all patients with reflux was 7.9 mm (range 2.2-12 mm). There was high inter-observer agreement for ovarian vein diameter for both sequences. TRICKS showed significantly greater conspicuity than T(2)/T2*W imaging (TRICKS: T(2)/T2* mean (SD) = 7.80 (3.20):5.50 (1.97), F (1,12) = 5.80, p < 0.05). TRICKS MRV demonstrated high inter-observer correlation for timing and grade of reflux (r (36) = 0.77,0.71,0.79, p < 0.01). TRICKS MRA/V was significantly degraded by breathing artefact in two patients. We conclude that TRICKS MRV accurately and dynamically demonstrates ovarian vein reflux in patients with PCS but requires quiet respiration. TRICKS MRV has better image conspicuity than T(2)/T2*W imaging and sufficient temporal resolution to distinguish between Grade I, II and III reflux.
Subject(s)
Magnetic Resonance Angiography/methods , Ovary/blood supply , Pelvic Pain/diagnosis , Phlebography/methods , Vascular Diseases/diagnosis , Adult , Aged , Contrast Media , Female , Humans , Imaging, Three-Dimensional , Middle Aged , Preoperative Care , Retrospective Studies , Syndrome , Vascular Diseases/physiopathologyABSTRACT
Time course changes in plasma creatine kinase activity during repetitive physical work were studied. Study groups consisted of a control group who performed sedentary administrative work and an experimental group who performed repetitive physical work in a biscuit factory. Venous blood samples were collected on a Monday prior to work and following work on Monday, Tuesday, Wednesday and Thursday and assayed for plasma creatine kinase. A rise in plasma creatine kinase was observed over the four working days and this rise was significantly greater for the experimental group. Despite this rise, creatine kinase values remained within acceptable limits for both groups. These results suggest that mild, repetitive physical work provides sufficient stimulus for creatine kinase release from skeletal muscle. The mechanism underlying the release of creatine kinase cannot be determined from the present study, but it is unlikely that muscle damage was the cause. It is proposed that increased plasma creatine kinase following mild occupational work may be related to increased rates of muscle turnover, stimulated by muscle use, and not be indicative of pathological processes associated with muscular strain and fatigue.
