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1.
Magn Reson Imaging ; 112: 54-62, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38909764

RESUMO

BACKGROUND: Magnetic resonance elastography (MRE) is a rapidly developing medical imaging technique that allows for quantitative assessment of the biomechanical properties of the tissue. MRE is now regarded as the most accurate noninvasive test for detecting and staging liver fibrosis. A two-dimensional (2D MRE) acquisition version is currently deployed at >2000 locations worldwide. 2D MRE allows for the evaluation of the magnitude of the complex shear modulus, also referred to as stiffness. The development of 3D vector MRE has enabled researchers to assess the biomechanical properties of small organs where wave propagation cannot be adequately analyzed with the 2D MRE imaging approach used in the liver. In 3D vector MRE, the shear waves are imaged and processed throughout a 3D volume and processed with an algorithm that accounts for wave propagation in any direction. Additionally, the motion is also imaged in x, y, and z directions at each voxel, allowing for more advanced processing to be applied. PURPOSE: This review describes the technical principles of 3D vector MRE, surveys its clinical applications in small organs, and discusses potential clinical significance of 3D vector MRE. CONCLUSION: 3D vector MRE is a promising tool for characterizing the biomechanical properties of small organs such as the uterus, pancreas, thyroid, prostate, and salivary glands. However, its potential has not yet been fully explored.

2.
NMR Biomed ; 37(2): e5047, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37813110

RESUMO

Magnetic resonance elastography (MRE) is an accurate noninvasive diagnostic tool for assessing the stiffness of parenchymal organs, including the spleen. However, this measurement may be biased due to postprandial changes in splenic stiffness. The aim of the current study was to evaluate postprandial changes in spleen stiffness assessed by MRE in a large sample of healthy volunteers. This was a prospective institutional research ethics board-approved study. Healthy volunteers with no history of liver disease were recruited for an MRE test and blood draw from December 2018 to July 2019. Each participant underwent spleen MRE after at least 4 h of fasting and again 30 min after a 1000 kcal meal. Also, 14 randomly selected volunteers underwent additional MRE examinations at 1.5 and 2.5 h after food intake. The MRE data were acquired at 60 Hz using a 1.5-T MRI scanner. The spleen stiffness was assessed using a weighted mean of stiffness values from regions of interest manually drawn on three to five spleen slices. Spearman's rank correlation, Wilcoxon signed-rank, Friedman, and Mann-Whitney tests were used for statistical analysis. A total of 100 volunteers met the inclusion criteria and were eventually enrolled in this study (age 23 ± 2 years; 65 women). The mean spleen stiffness for the whole group increased by 7.9% (p < 0.001) from the mean ± SD value of 5.09 ± 0.63 (95% CI: 4.96-5.21) kPa in the fasting state to 5.47 ± 0.66 (95% CI 5.34-5.60) kPa 30 min after the meal and then gradually decreased. However, even 2 h 30 min after the meal, the spleen stiffness was higher than in the fasting state. This difference was statistically significant at p less than 0.001. It was concluded that meal intake results in a statistically significant elevation of spleen stiffness that persists for 2.5 h. This finding supports the recommendation for routine fasting for more than 2.5 h prior to assessing MRE-based spleen stiffness.


Assuntos
Técnicas de Imagem por Elasticidade , Baço , Humanos , Feminino , Adulto Jovem , Adulto , Baço/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Estudos Prospectivos , Reprodutibilidade dos Testes , Imageamento por Ressonância Magnética/métodos
3.
Diagnostics (Basel) ; 13(17)2023 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-37685274

RESUMO

PURPOSE: Magnetic resonance elastography (MRE) has been established as the most accurate noninvasive technique for diagnosing liver fibrosis. Recent publications have suggested that the measurement of splenic stiffness is useful in setting where portal hypertension may be present. The goal of the current study was to compile normative data for MRE-assessed stiffness measurements of the spleen in young adults. MATERIALS AND METHODS: A total of 100 healthy young Caucasian volunteers (65 females and 35 males) in the age range of 20 to 32 years were enrolled in this study. The participants reported no history of chronic spleen and liver disease, normal alcohol consumption, and a normal diet. The MRE data were acquired by using a 1.5 T whole-body scanner and a 2D GRE pulse sequence with 60 Hz excitation. Spleen stiffness was calculated as a weighted mean of stiffness values in the regions of interest manually drawn by the radiologist on three to five spleen slices. RESULTS: Mean spleen stiffness was 5.09 ± 0.65 kPa for the whole group. Male volunteers had slightly higher splenic stiffness compared to females: 5.28 ± 0.78 vs. 4.98 ± 0.51 kPa, however, this difference was not statistically significant (p = 0.12). Spleen stiffness did not correlate with spleen fat content and liver stiffness but a statistically significant correlation with spleen volume was found. CONCLUSIONS: The findings of this study provide normative values for 2D MRE-based measurement of spleen stiffness in young adults, a basis for assessing the value of this biomarker in young patients with portal system pathologies.

4.
Healthcare (Basel) ; 11(18)2023 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-37761678

RESUMO

Uterine fibromas are the most common benign uterine tumors. Although the majority of leiomyomas remain asymptomatic, they can cause serious clinical problems, including abnormal uterine bleeding, pelvic pain, and infertility, which require effective gynecological intervention. Depending on the symptoms as well as patients' preferences, various treatment options are available, such as medical therapy, non-invasive procedures, and surgical methods. Regardless of the extent of the surgery, the preferred option is the laparoscopic approach. To reduce the risk of spreading occult malignancy and myometrial cells associated with fragmentation of the specimen before its removal from the peritoneal cavity, special systems for laparoscopic contained morcellation have been developed. The aim of this review is to present the state-of-the-art contained morcellation. Different types of available retrieval bags are demonstrated. The advantages and difficulties associated with contained morcellation are described. The impact of retrieval bag usage on the course of surgery, as well as the effects of the learning curve, are discussed. The role of contained morcellation in the overall strategy to optimize patient safety is highlighted.

5.
J Clin Med ; 11(12)2022 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-35743348

RESUMO

Tubal diseases account for 25-40% of female factor infertility. Mainly, they involve the distal part of the fallopian tube, and hydrosalpinx is the most severe manifestation. Usually, the management decision is made between reconstructive surgery and ART, depending on the severity of the tubal damage, patient age, ovarian reserve, and seminogram, as well as financial, religious, ethical, and psychological factors. Estimated live-birth rates after corrective surgery range from 9% to 69%. The success rate of IVF is about 30% live-birth rate per cycle initiated in women across all ages with tubal factor infertility. Surgery offers a long-term cure and patients may attempt conception many times but are burdened with perioperative adverse events. IVF bypasses potential complications of operative treatment; however, this has its own unique risks. The effectiveness of reconstructive surgery versus ART has not been adequately evaluated. The success of fertility management depends on a thorough interpretation of existing data and careful patient selection. The presented review provides updates on the most recent progress in this area.

6.
Ginekol Pol ; 93(5): 369-373, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35315008

RESUMO

OBJECTIVES: Morcellation is an integral part of laparoscopic procedures related to uterine fibroids, which consist of the mechanical fragmentation of the tumor and its extraction outside the abdominal cavity. To avoid the risk of tissue dissemination, special extraction systems have been developed, which allow morcellation of the specimen under visual control and its removal without contact with the abdominal organs. The aim of the paper is to compare the two systems for laparoscopic morcellation. MATERIAL AND METHODS: The study included 33 premenopausal women with symptomatic leiomyomas or adenomyosis, who were qualified for laparoscopic surgery with contained power morcellation. Patients were allocated alternately to a different tissue extraction system's group. According to the study protocol, selected operative parameters were prospectively recorded. Finally, an assessment of bag use was performed. The data was statistically analyzed. RESULTS: There were significant differences between the two tested systems in terms of introducing and positioning the bag, its removal from the peritoneal cavity, as well as optic trocar insertion and establishing the pseudo-peritoneum. CONCLUSIONS: Despite the minor design differences and some ergonomic aspects, both presented systems proved to be safe and feasible tools for laparoscopic contained morcellation. This technique both reduces the risk of tissue dissemination and preserves the advantages of minimal invasiveness.


Assuntos
Laparoscopia , Leiomioma , Morcelação , Miomectomia Uterina , Neoplasias Uterinas , Humanos , Feminino , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/patologia , Miomectomia Uterina/métodos , Morcelação/efeitos adversos , Morcelação/métodos , Leiomioma/cirurgia , Leiomioma/patologia , Laparoscopia/métodos , Histerectomia/métodos , Peritônio/patologia
7.
Sci Rep ; 11(1): 19786, 2021 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-34611231

RESUMO

Magnetic resonance elastography (MRE) is a reliable noninvasive method for assessment of hepatic stiffness. Liver stiffness is known to be affected by elevated postprandial portal blood flow in patients with chronic liver disease. The goal of this study was to determine whether food intake affects liver stiffness in the absence of known liver disease. We evaluated 100 volunteers (35 men and 65 women) who met inclusion criteria. The subjects had two MRE examinations, first while fasting and then 30 min after a test meal. Fourteen subjects also had two additional MRE exams 1 h 30 min and 2 h 30 min after the meal. Liver stiffness was measured by placing the largest possible polygon ROIs on the four widest liver slices and calculated as a mean of stiffness values from each slice. The correlation of liver stiffness values before and after the meal was assessed using a paired t-test. To evaluate the relationship between the change in postprandial liver stiffness and fasting liver stiffness values, linear regression was performed. The liver stiffness values in the fasting state ranged from 1.84 to 2.82 kPa, with a mean of 2.30 ± 0.23 kPa (95% CI 2.25-2.34). At 30 min after the meal, liver stiffness values ranged from 2.12 to 3.50 kPa, with a mean of 2.70 ± 0.28 kPa (95% CI 2.64-2.75), demonstrating a systematic postprandial increase by 0.40 ± 0.23 kPa (17.7 ± 3.5%). Meal intake significantly increases liver stiffness in healthy individuals, which persists for at least 2 h 30 min. Patients should fast for 3-4 h before MRE examinations to avoid fibrosis overstaging due to postprandial liver stiffness augmentation.


Assuntos
Técnicas de Imagem por Elasticidade , Fígado/diagnóstico por imagem , Imageamento por Ressonância Magnética , Período Pós-Prandial , Biomarcadores , Técnicas de Imagem por Elasticidade/métodos , Feminino , Voluntários Saudáveis , Humanos , Processamento de Imagem Assistida por Computador , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/patologia , Hepatopatias/diagnóstico por imagem , Hepatopatias/patologia , Imageamento por Ressonância Magnética/métodos , Masculino , Análise Multivariada
8.
Sci Rep ; 10(1): 17887, 2020 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-33087836

RESUMO

Iron overload is a relatively common clinical condition resulting from disorders such as hereditary hemochromatosis, thalassemia, sickle cell disease, and myelodysplasia that can lead to progressive fibrosis and eventually cirrhosis of the liver. Therefore, it is essential to recognize the disease process at the earliest stage. Liver biopsy is the reference test for the assessment of liver fibrosis. It also allows for quantifying liver iron concentration (LIC) in patients. However, this is an invasive method with significant limitations and possible risks. Magnetic resonance imaging (MRI) and evaluation of the R2* relaxation rate can be an alternative to biopsy for assessing LIC. However, it causes a need for accurate R2* data corresponding to standard value for further comparison with examined patients. This study aimed to assess the normative values of liver R2* in healthy individuals. A total of 100 volunteers that met established criteria were enrolled in the study: 36 (36%) men and 64 (64%) women. The mean age was 22.9 years (range 20 to 32 years). R2* was estimated by an MRI exam with a 1.5 T clinical magnetic resonance scanner. Images for measuring the LIC and liver fat concentration were obtained using the IDEAL-IQ technique for liver imaging. The Mean (SD) liver R2* was 28.34 (2.25) s-1 (95% CI, 27.78-28.90, range 23.67-33.00 s-1) in females, 29.57 (3.20) s-1 (95% CI, 28.49-30.66, range 23.93-37.77 s-1) in males, and 28.72 (2.69) s-1 (range 23.67-37.77 s-1) in the whole group. R2* value in this particular population with a high proportion of young women did not exceed 38 s-1. In the absence of fibrosis or steatosis, liver stiffness and fat fraction did not show any relationship with R2*.


Assuntos
Sobrecarga de Ferro/diagnóstico por imagem , Ferro/metabolismo , Fígado/diagnóstico por imagem , Adulto , Feminino , Voluntários Saudáveis , Humanos , Interpretação de Imagem Assistida por Computador , Fígado/metabolismo , Imageamento por Ressonância Magnética , Masculino , Adulto Jovem
9.
Ginekol Pol ; 91(7): 373-378, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32542642

RESUMO

OBJECTIVES: To evaluate magnetic resonance elastography as a tool for characterizing uterine leimyomas. MATERIAL AND METHODS: At total of 12 women with symptomatic leiomyomas diagnosed in physical and ultrasound examinations were enrolled in this pilot study. Before surgery, all patients underwent magnetic resonance elastography of the uterus using a 1.5 T MR whole-body scanner (Optima, GE Healthcare, Milwaukee, WI, USA). Surgical specimens were forwarded for histological examination. The findings were allocated into 3 categories depending on the percentage content of connective tissue: below 15%, from 15 to 30% and more than 30%. The median stiffness of leiomyomas for each of the group was calculated. The U-Mann Whitney test was used for statistical analysis. RESULTS: The stiffness of the leiomyomas ranged between 3.7-6.9 kPa (median value 4.9 kPa). The concentration of extracellular components in the leiomyomas did not exceed 40%. An increasing trend of the stiffness with the growing percentage of extracellular component was observed. Stiffness of the leiomyomas obtained by MRE varies depending on microscopic composition. CONCLUSIONS: The value of stiffness shows a trend of increasing with the percentage of extracellular component of the leiomyoma. Further studies are required to assess the usefulness of MRE in diagnostics of uterine leiomyomas.


Assuntos
Leiomioma/diagnóstico por imagem , Neoplasias Uterinas/diagnóstico por imagem , Adulto , Técnicas de Imagem por Elasticidade , Feminino , Humanos , Leiomioma/fisiopatologia , Leiomioma/cirurgia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Projetos Piloto , Neoplasias Uterinas/fisiopatologia , Neoplasias Uterinas/cirurgia , Adulto Jovem
11.
Prz Menopauzalny ; 18(2): 123-125, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31485209

RESUMO

INTRODUCTION: Uterine leiomyomas are the most common neoplasm of the uterus in women. Massive lymphocytic infiltration in a myoma is an unusual finding. It is characterised by the varying intensity of lymphocyte infiltration, the presence of scattered plasma cells, eosinophilia, and rarely, other items. We would like to call attention to such a rare lesion. CASE DESCRIPTION: We present the case of a 31-year-old woman who had undergone surgical excision of a uterine tumour. Grossly, it had the typical uterine smooth muscle wall consistency. The microscopic examination revealed leiomyoma with heavy infiltration composed mainly of lymphocytes. On immunohistochemistry, in the lymphocytic infiltrate the T mature (CD3+/CD5+/TdT-) lymphocytes, small and of cytotoxic (CD8+/CD56-) type, prevailed, with moderate proliferative activity (expression of Ki67 found in ca. 30-40% of the cells), whereas B lymphocytes (CD20+/CD5-/TdT-) were innumerous and present in nodular aggregates. Despite a strong suspicion of neoplastic lymphoproliferation, the histopathological diagnosis was: leiomyoma with massive lymphoid infiltration. The cause of this feature is not known, although the gonadotropin-releasing hormone agonist and post-menopausal processes may promote such transformations. In differential diagnosis, malignant lymphoma, inflammatory pseudotumour, and pyomyoma should be included. CONCLUSIONS: Lymphocytic infiltration within the uterine myoma is rare. The recognition of its distinct histological features is important to avoid possible misdiagnosis.

12.
J Cancer ; 10(18): 4189-4195, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31413737

RESUMO

Background: Toward the goal of predicting individual long-term cancer survival to guide treatment decisions, this study evaluated the ability of a probabilistic neural network (PNN), an established model used for decision-making in research and clinical settings, to predict the 10-year overall survival in patients with cervical cancer who underwent primary surgical treatment. Patients and Method: The input dataset was derived from 102 patients with cervical cancer FIGO stage IA2-IIB treated by radical hysterectomy. We identified 4 demographic parameters, 13 tumor-related parameters, and 6 selected perioperative variables for each patient and performed computer simulations with DTREG software. The predictive ability of the model was determined on the basis of its error, sensitivity, and specificity, as well as area under the receiver operating characteristic curve. The results of the PNN predictive model were compared with those of logistic regression analysis and a single decision tree as reference models. Results: The PNN model had very high predictive ability, with a sensitivity of 0.949, a specificity of 0.679, and an error rate of 12.5%. The PNN's area under the receiver operating characteristic curve was high, 0.809, a value greater than those for both logistic regression analysis and the single decision tree. Conclusion: The PNN model effectively and reliably predicted 10-year overall survival in women with operable cervical cancer, and may therefore serve as a tool for decision-making process in cancer treatment.

13.
Pol Arch Intern Med ; 129(5): 321-326, 2019 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-30793705

RESUMO

INTRODUCTION Chronic liver disease resulting in fibrosis, and ultimately cirrhosis, is a significant cause of morbidity and mortality worldwide. None of the conventional imaging techniques are able to detect early fibrosis and compare its grade with the histopathologic scale. Liver biopsy, as the diagnostic standard for liver fibrosis, also has limitations and is not well accepted by patients. Magnetic resonance elastography is a well­established technique for evaluating liver stiffness and may replace invasive procedures. Detection of liver fibrosis in its early stages, however, requires a detailed knowledge of normal liver stiffness. OBJECTIVES This study aimed to determine normal liver stiffness values in healthy volunteers. PATIENTS AND METHODS A total of 102 volunteers (mean age, 21.6 years; range, 20-28 years) with no history of gastrointestinal, hepatobiliary, or cardiovascular disease were enrolled in the study. Liver stiffness was evaluated by magnetic resonance elastography with a 1.5T clinical magnetic resonance scanner. Images of the induced transverse wave propagation were obtained and converted to tissue stiffness maps (elastograms). RESULTS The mean (SD) liver stiffness for the entire group of volunteers was 2.14 (0.28) kPa (range, 1.37-2.66 kPa). For women, the mean (SD) stiffness value was 2.14 (0.30) kPa (range, 1.37-2.66 kPa), and for men, 2.14 (0.25) kPa (range, 1.54-2.54 kPa). CONCLUSIONS Liver stiffness in a healthy adult cohort did not exceed 2.7 kPa and is not influenced by sex, body mass index, or fat content.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Fígado/anatomia & histologia , Adulto , Feminino , Humanos , Fígado/diagnóstico por imagem , Cirrose Hepática/diagnóstico por imagem , Masculino , Valores de Referência , Adulto Jovem
14.
Prz Menopauzalny ; 17(1): 28-31, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29725282

RESUMO

INTRODUCTION: Core needle biopsy is a preferable breast biopsy technique under ultrasound guidance. However, fine-needle biopsy is considered equally popular. AIM OF THE STUDY: To redefine the role of fine-needle aspiration biopsy (FNAB) in the diagnosis of breast lesions. MATERIAL AND METHODS: We retrospectively analysed the medical records of 680 patients who underwent breast ultrasound examination. In most cases, no pathologic structures were observed within the mammary glands. In 321 patients, the presence of focal lesions was revealed, and 107 patients in this group qualified for FNAB according to current recommendations. Patients with suspicious smears were referred for core needle or surgical biopsy. Patients with benign cytological smears underwent repeated ultrasound checks at 6-month intervals during the following year. RESULTS: All the smears were diagnostic. The vast majority of the results were categorised as benign lesions. Cancer cells were detected in six women. In one patient the lesion was classified as suspicious, probably malignant. In all of these cases, open biopsy was performed, and histopathological examination confirmed the presence of a malignant tumour. The patients were given appropriate oncological treatment. For women with benign or suspicious, but probably benign, lesions, breast ultrasound was performed twice at six-month intervals. Control tests showed no significant changes compared to the baseline examination. None of the patients required extensive additional diagnostic tests. CONCLUSIONS: FNAB is a reliable method of assessing pathologic lesions in mammary glands.

15.
BMC Cancer ; 17(1): 840, 2017 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-29233120

RESUMO

BACKGROUND: Computational intelligence methods, including non-linear classification algorithms, can be used in medical research and practice as a decision making tool. This study aimed to evaluate the usefulness of artificial intelligence models for 5-year overall survival prediction in patients with cervical cancer treated by radical hysterectomy. METHODS: The data set was collected from 102 patients with cervical cancer FIGO stage IA2-IIB, that underwent primary surgical treatment. Twenty-three demographic, tumor-related parameters and selected perioperative data of each patient were collected. The simulations involved six computational intelligence methods: the probabilistic neural network (PNN), multilayer perceptron network, gene expression programming classifier, support vector machines algorithm, radial basis function neural network and k-Means algorithm. The prediction ability of the models was determined based on the accuracy, sensitivity, specificity, as well as the area under the receiver operating characteristic curve. The results of the computational intelligence methods were compared with the results of linear regression analysis as a reference model. RESULTS: The best results were obtained by the PNN model. This neural network provided very high prediction ability with an accuracy of 0.892 and sensitivity of 0.975. The area under the receiver operating characteristics curve of PNN was also high, 0.818. The outcomes obtained by other classifiers were markedly worse. CONCLUSIONS: The PNN model is an effective tool for predicting 5-year overall survival in cervical cancer patients treated with radical hysterectomy.


Assuntos
Histerectomia/estatística & dados numéricos , Redes Neurais de Computação , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Curva ROC , Máquina de Vetores de Suporte , Análise de Sobrevida , Neoplasias do Colo do Útero/epidemiologia
16.
Oncology ; 93(2): 106-114, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28463843

RESUMO

OBJECTIVE: We assessed the prognostic factors related to 10-year overall survival and disease-free survival in cervical cancer patients that underwent primary surgical protocols in 1 institution. MATERIALS AND METHODS: A total of 102 patients with uterine cervical cancer at FIGO stages IA2-IIB that underwent a Piver type III radical hysterectomy and pelvic lymphadenectomy between 1998 and 2001 were included. Univariate and multivariate analyses of 10-year overall survival and 10-year disease-free survival were performed. RESULTS: Univariate analysis revealed that only lymphovascular space invasion significantly affected 10-year overall survival (p = 0.04), but it had no effect on the 10-year disease-free survival rate. Multivariate analysis demonstrated that survival rates were significantly affected by FIGO stage (p = 0.02, 95% CI: 1.18-5.55, for 10-year overall survival; p = 0.03, 95% CI: 1.07-6.12, for 10-year disease-free survival) and metastases to the pelvic lymph nodes (p = 0.0005, 95% CI: 1.81-8.53, for 10-year overall survival; p = 0.01, 95% CI: 1.26-7.24, for 10-year disease-free survival). CONCLUSIONS: The only independent prognostic factors for 10-year survival rates in patients with cervical cancer at FIGO stages IA2-IIB were clinical stage and presence of metastases to the pelvic lymph nodes. The presence of lymphovascular space invasion adversely affected 10-year overall survival.


Assuntos
Adenocarcinoma/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Adulto , Idoso , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Histerectomia , Excisão de Linfonodo , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Polônia , Prognóstico , Estudos Prospectivos , Análise de Sobrevida , Resultado do Tratamento , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapia , Saúde da Mulher
17.
Ginekol Pol ; 81(5): 386-8, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20568522

RESUMO

UNLABELLED: To present a rare case of spontaneous ectopic pregnancy in a non-communicating heterotopic fallopian tube associated with unicornuate uterus without a rudimentary horn. Case report. SETTING: Tertiary referral obstetrics and gynecology center. PATIENT: A 36-year-old woman in her fourth pregnancy (para 1, abortus 2) presented at 5th gestational week with severe abdominal pain and circulatory instability. INTERVENTION: Heterotopic fallopian tube removal by laparotomy. Investigation of the origin of the spontaneous heterotopic fallopian tube pregnancy and exploration of the gross structural development of the urinary system. Spontaneous ectopic pregnancy in a non-communicating heterotopic fallopian tube coexisting with corpus luteum in the contralateral ovary supports the hypothesis of transperitoneal migration of gametes or embryos.


Assuntos
Embrião de Mamíferos/diagnóstico por imagem , Tubas Uterinas/diagnóstico por imagem , Hemoperitônio/diagnóstico por imagem , Gravidez Tubária/diagnóstico por imagem , Gravidez Tubária/cirurgia , Adulto , Tubas Uterinas/anormalidades , Feminino , Hemoperitônio/patologia , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Resultado do Tratamento , Ultrassonografia Pré-Natal , Útero/anormalidades , Útero/diagnóstico por imagem
18.
Ginekol Pol ; 79(6): 404-9, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18652127

RESUMO

OBJECTIVES: The aim of the study was to evaluate the value of intraoperative assessment of depth of myometrial invasion in patients with FIGO stage I of the endometrial carcinoma. MATERIAL AND METHODS: A total number of 112 patients with FIGO stage I of the endometrial carcinoma undergoing surgery were enrolled in the study. All patients had undergone intraoperative assessment of the depth of myometrial invasion performed by a surgeon. The depth was determined as more or less than 50% of myometrial thickness according to FIGO classification. Gross visual estimation of the depth of myometrial invasion at the time of the operation was compared with the final histopathological report. Sensitivity, specificity and positive and negative predictive values of the method were determined by means of statistical analyses. RESULTS: The depth of the myometrial invasion was accurately determined by the surgeon in 82.1% of cases. Sensitivity and specificity were 68% and 82.1%, respectively. The accurate prediction rate of the myometrial invasion in the group of patients with well differentiated (G1) endometrial carcinoma was higher (88.4%) than in group with moderately and low differentiated tumour (78.3%). CONCLUSIONS: The accuracy of macroscopic evaluation of myometrial invasion is high and reaches up to 82.1%. The accurate determination rate increases if the differentiation of tumour is higher.


Assuntos
Carcinoma Endometrioide/patologia , Carcinoma Endometrioide/cirurgia , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/cirurgia , Adulto , Idoso , Feminino , Humanos , Período Intraoperatório , Pessoa de Meia-Idade , Miométrio/patologia , Invasividade Neoplásica , Estadiamento de Neoplasias , Polônia , Valor Preditivo dos Testes , Estudos Prospectivos
19.
Radiat Prot Dosimetry ; 114(1-3): 326-31, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15933131

RESUMO

This paper presents the results of phantom studies to investigate possible dose reduction in relation to image quality in head examinations. The studies were performed using five single-slice computed tomography (CT) scanners. Beginning from the manufacturer's protocols (i.e. default protocols in the scanner software) for routine head (adult) examinations, the values of kV(p), anode current and time were modified. Low-contrast resolution and spatial resolution were controlled using a Catphan 424 phantom. Radiation dose was checked using a polymethylmethacrylate phantom and a pencil ionisation chamber. It was found that CT dose index may be reduced up to three times with practically no loss of image quality.


Assuntos
Cabeça/diagnóstico por imagem , Imagens de Fantasmas , Tomografia Computadorizada por Raios X/instrumentação , Tomografia Computadorizada por Raios X/métodos , Humanos , Processamento de Imagem Assistida por Computador , Modelos Estatísticos , Doses de Radiação , Intensificação de Imagem Radiográfica , Radiometria , Software , Tomógrafos Computadorizados
20.
Med Pr ; 53(5): 381-6, 2002.
Artigo em Polonês | MEDLINE | ID: mdl-12577805

RESUMO

Exposure of patients, known as medical exposure, is an inevitable consequence of the diagnostic and therapeutic application of ionizing radiation. This includes among others radioisotope examination in vivo. The authors evaluate diagnostic radioisotope examinations in vivo, as an artificial source of patients' exposure, in comparison with radiological diagnostics, the most common type of medical exposure, and diagnostic methods, employing physical agents other than ionizing radiation (ultrasound, magnetic field). It is expected that the results of the evaluation will provide the justifying grounds for a sensible choice of a diagnostic method among those available. On the basis of the precise data collected in 21 laboratories, the frequency of radioisotope examinations during the years 1998-2000 was estimated at about three per 1000 inhabitants. It was found that the examination of the thyroid gland, skeleton and heart were performed most frequently. The information gathered and the literature data helped to calculate an average dose per one inhabitant of Poland. The values are as follows: average effective dose per one examination--6 mSv; average effective dose per one inhabitant--0.033 mSv. It should be stressed that apart from the examinations of the thyroid gland performed with use of 1311 (16% of the total number of examinations), the average effective dose received by patients during other examinations is equal to only 2.2 mSv. Finally, the authors present the data on patients' exposure during radioisotope examinations and diagnostic examinations employing other methods. They indicate that many radioisotope examinations provide valuable diagnostic information that could not be obtained by means of other methods. Moreover, these examinations involve relatively low levels of effective doses received by patients.


Assuntos
Exposição Ambiental , Lesões por Radiação/prevenção & controle , Radiação Ionizante , Radioisótopos/efeitos adversos , Exposição Ambiental/efeitos adversos , Exposição Ambiental/prevenção & controle , Feminino , Humanos , Masculino , Polônia/epidemiologia , Vigilância da População , Doses de Radiação , Lesões por Radiação/epidemiologia , Compostos Radiofarmacêuticos/efeitos adversos , Estudos Retrospectivos
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