ABSTRACT
BACKGROUND: The endometrium and uterine junction zone often change throughout the menstrual cycle. Some pathological conditions may appear normal in uterine imaging, which will lead to missed diagnosis and misdiagnosis. PURPOSE: To evaluate the changes in the thickness and apparent diffusion coefficient (ADC) values of the endometrium and uterine junction zone throughout the menstrual cycle in magnetic resonance imaging (MRI) of women of reproductive age. MATERIAL AND METHODS: Data were collected from 40 healthy women of reproductive age with regular menstrual cycles from January 2017 to April 2018. They underwent four total MRI sessions during the menstrual, proliferation, and early and late secretive phases. The main MRI sequences were T2-weighted (T2W) volume isotropic turbo spin echo acquisition (VISTA) spectral attenuated inversion recovery (SPAIR) and diffusion-weighted imaging (b = 0, 600, 800, 1000 s/mm2), which were used to measure the thicknesses and ADC values of endometrium and uterine junction zone. RESULTS: First, the endometrium was thinnest during the menstrual phase and thickest in the late secretive phase. Second, the uterine junction zone was thinnest in the late secretive phase and thickest in the menstrual phase. Third, the ADC values of the endometrium were lowest in the menstrual phase and peaked in the early secretive phase. Finally, the ADC values of the uterine junction zone were lowest in the menstrual phase and peaked in the late secretive phase. CONCLUSION: The endometrium and uterine junction zone showed cyclic changes. Radiologists should consider these changes in the thickness and ADC values when analyzing MRI images of the uterus.
Subject(s)
Endometrium , Uterus , Female , Humans , Endometrium/diagnostic imaging , Uterus/diagnostic imaging , Diffusion Magnetic Resonance Imaging/methods , Magnetic Resonance Imaging , Menstrual CycleABSTRACT
Objective:To investigate the effect of dexmedetomidine (DEX) on reducing urethral stimulation in patients undergoing laparoscopic gastrointestinal surgery.Methods:From January 2019 to February 2020, 90 patients undergoing elective laparoscopic gastrointestinal surgery under general anesthesia in the Third Affiliated Hospital of Sun Yat-sen University were selected. They were randomly divided into 3 groups: catheterization before induction (group A), catheterization during induction (group B), and catheterization after induction (group C). In group A, patients received general anesthesia after awake catheterization. In group B, intravenous injection of DEX 0.5 μg/kg was pumped for 10 minutes, followed by catheterization and induction. In group C, patients received general anesthesia and then catheterization. Visual analogue scale (VAS) score of urethral stimulation, morphine dosage and the incidence of agitation during resuscitation were recorded. The heart rate and mean arterial pressure of the three groups were compared at the time of entering the room, catheterization, tracheal intubation, entering postanesthesia care unit (PACU), about extubation and 30 minutes after extubation.Results:The fluctuation of blood pressure and heart rate in group B was significantly less than that in group A and group C at the time of extubation and 30 minutes after extubation ( P<0.05). VAS of urethral stimulation in group B [(2.9±0.9)point] was significantly lower than that in group A [(4.4±1.8)point] when catheter was indwelling ( P<0.05). After extubation, VAS in group B [(2.8±1.1)point] was significantly lower than that in group A [(3.2±1.2)point] and C [(5.2±1.8)point] ( P<0.05). The utilization rate of morphine within 24 hours after surgery in group B (10%) was significantly lower than that in the other two groups (40%, 57%), and the incidence of postoperative agitation in group A and B was lower than that in group C within PACU ( P<0.05). The satisfaction of patients in group B (86.7%) was higher than that in group A (70%) and C (46.7%). The satisfaction of PACU personnel in group A (76.7%) and B (80%) was significantly higher than that in group C (43.3%). Conclusions:Sedation with dexmedetomidine during urethral catheterization can reduce urethral stimulation during resuscitation and improve patients' and PACU staffs' satisfaction.
ABSTRACT
Objective To demonstrate that MRI is more advantageous than ultrasound in the detection of ischemic cerebral lesions precisely in twin-twin transfusion syndrome(TTTS)fetus following fetoscopic selective laser coagulation(SLCPV).Methods The fetus with TTTS treated by SLCPV were collected.All fetuses underwent brain MRI within 1-5 days after the procedure and a follow-up MRI at 29-32 weeks'gestation.All fetuses also had frequent ultrasound evaluation until delivery.Results Twenty-five pregnancies with TTTS were included in the study.Six pregnancies resulted in survival of only one twin after the procedure(Group A),while the other 19 pregnancies resulted in the survival of both twins(Group B),as assessed at the time of initial MRI.Two fetus in Group A and three in Group B had evidence of bleeding in lateral ventricle.Two fetus in Group B had actue brain ischemia.One fetus in Group B had appeared brain atrophy and choosed to terminate pregnancy.Conclusion MRI can make a clearer diagnosis of cerebral damage of TTTS fetus in a short period after SLCPV.
