ABSTRACT
This article describes the basic technology and technique behind modified virtual colonoscopy (MVC). It is accompanied by images illustrating the possibility of MVC to advance the imaging for endometriosis beyond the current modalities of magnetic resonance imaging (MRI) and ultrasound. A quantification system is described that will ultimately make staging and multicenter prospective scientific studies possible for rectogenital and disseminated endometriosis.
Subject(s)
Colonic Diseases/diagnostic imaging , Colonography, Computed Tomographic/methods , Endometriosis/diagnostic imaging , Radiography, Abdominal/methods , Female , Humans , Image Interpretation, Computer-Assisted/methodsABSTRACT
BACKGROUND: Advanced HIV infection can result in lipoatrophy and wasting, even in the absence of ongoing opportunistic infections, suggesting that HIV may directly affect adipose tissue amount and distribution. METHODS: We assessed the relationship of fat (measured using anthropometry, DEXA, MRI scans) or markers related to glucose and lipid metabolism with viral load in a cross-sectional sample of 83 antiretroviral-naïve HIV-1-infected South African women. A multivariable linear model was fitted to log10VL to assess the combined effect of these variables. RESULTS: In addition to higher T cell activation, women with viral load greater than the population median had lower waist circumference, body mass index and subcutaneous abdominal fat, as well as lower serum leptin. We demonstrate that leptin serum levels are inversely associated with viral replication, independent of the amount of adipose tissue. This association is maintained after adjusting for multiple variables associated with disease progression (i.e., cellular activation and innate immunity effector levels). CONCLUSIONS: Our results demonstrate that serum leptin levels are inversely associated with viral replication, independent of disease progression: we postulate that leptin may affect viral replication.
Subject(s)
HIV Infections/virology , HIV-1/growth & development , Leptin/blood , Adult , Body Fat Distribution , Cross-Sectional Studies , Female , Glucose/metabolism , Humans , Lipid Metabolism , South Africa , Viral LoadABSTRACT
In this study, we modified the standard virtual colonoscopy technique to diagnose deep infiltrating pelvic endometriosis. The following modifications were used: (1) insertion of a large obstetric tampon high into the vagina; (2) insertion of a Foley catheter into the rectum and insufflation with CO(2); and (3) scanning only the pelvis. We used a Toshiba Aquillion 64-multidetector computed tomography scanner coupled to a 3-D workstation. By employing various reconstruction modules such as endo-luminal fly-through, cubed volume, 2-D multiplanar reconstruction, 3-D transparent view, and 3-D volume-rendered and maximum intensity projection, we were able to demonstrate deep infiltrating pelvic endometriosis in bowel, urinary tract, and rectovaginal and retroperitoneal spaces.
