RESUMO
Hemato/hydrocolpos due to congenital urogenital anomalies are rare conditions discovered in neonatal, infant, and adolescent girls. Diagnosis is often missed or delayed owing to its rare incidence and nonspecific symptoms. If early correct diagnosis and treatment cannot be performed, late complications such as tubal adhesion, pelvic endometriosis, and infertility may develop. Congenital urogenital anomalies causing hemato/hydrocolpos are mainly of four types: imperforate hymen, distal vaginal agenesis, transverse vaginal septum, and obstructed hemivagina and ipsilateral renal anomaly, and clinicians should have adequate knowledge about these anomalies. This article aimed to review the diagnosis and treatment of these urogenital anomalies by describing embryology, clinical presentation, imaging findings, surgical management, and postoperative outcomes.
Assuntos
Hidrocolpos , Feminino , Humanos , Hidrocolpos/diagnóstico por imagem , Hidrocolpos/cirurgia , Rim/diagnóstico por imagem , Rim/cirurgia , Nefropatias , Anormalidades Urogenitais/complicações , Anormalidades Urogenitais/diagnóstico por imagem , Anormalidades Urogenitais/cirurgia , Vagina/diagnóstico por imagem , Vagina/cirurgiaRESUMO
ABSTRACT: To investigate whether chemical shift imaging (CSI) is useful for differentiating myelomatous infiltration from hematopoietic bone marrow (BM) and for quantitatively assessing disease severity.In this retrospective study, spinal MRI, including a sagittal iterative decomposition of water and fat with echo asymmetry and least-squares estimation T2 fast spin-echo sequence, was performed on 76 myeloma patients (45 men, 67.0â±â11.4âyears; 31 women, 66.5â±â11.0âyears) and 30 control subjects (20 men, 67.0â±â8.4âyears; 10 women, 67.0â±â9.2âyears). The fat-signal fraction (FF) and mean signal dropout ratio (DR) were calculated from lumbar BM that contained no focal lesions. The BM plasma cell percentage (BMPC%) and serological data were obtained. As DR is highest when FFâ=â50%, the patients were divided into 2 groups: a water-dominant group (FFâ<â50%) and a fat-dominant group (FF > 50%).Serum monoclonal protein (M protein), ß2-microglobulin, and BMPC% were significantly higher in the water-dominant group than in the fat-dominant group. In the water-dominant group, DR correlated significantly with BMPC% and M protein, whereas in the control group, DR showed a weak correlation with age but no correlation with other clinical factors. No significant differences in any clinical data were seen between high and low DR.CSI proved ineffective for differentiating myelomatous infiltration from hematopoietic BM. For myeloma patients with relatively high BM cellularity, a small signal drop on opposed-phase images indicated a higher tumor burden. For BM with relatively low cellularity, disease severity was not reflected by CSI.
Assuntos
Imageamento por Ressonância Magnética , Mieloma Múltiplo/diagnóstico por imagem , Idoso , Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Imageamento por Ressonância Magnética/métodos , Masculino , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/patologia , Estudos Retrospectivos , Índice de Gravidade de DoençaAssuntos
Fragilidade , Hipestesia , Extremidades , Feminino , Humanos , Hipestesia/etiologia , Pessoa de Meia-Idade , Debilidade Muscular/etiologiaAssuntos
Estado de Consciência , Hemorragia Pós-Parto , Feminino , Humanos , Hemorragia Pós-Parto/etiologia , GravidezAssuntos
Tontura , Hipestesia , Tontura/etiologia , Cefaleia/etiologia , Humanos , Hipestesia/etiologia , Fala , VertigemRESUMO
PURPOSE: To evaluate the opacity of DC beads® (DCB) loaded with mineral ions on low-keV monochromatic images from dual energy computed tomography (DECT) and T1-weighted gradient-echo (T1-GRE) MRI. MATERIALS AND METHODS: Fe2+ or Ca2+-loaded DCBs were prepared by mixing DCBs in 100 mM FeSO4 or CaSO4 solution and scanned by DECT from 10 min to 27 h after mixing. The Hounsfield units (HUs) of sedimented DCBs on 40-keV monochromatic images were measured. Next, we mixed DCBs in 100, 10, 5 and 1 mM FeSO4 solutions, and scanned these solutions from 15 to 120 min after mixing using a 3 T MR scanner. The signal-noise ratios (SNRs) of sedimented DCBs on T1-GRE were measured. Venous blood was scanned to compare with DCBs. RESULTS: The CT values of DCBs in FeSO4 and CaCl2 solutions gradually increased, and were 113.3 and 43.1 HU at 27 h, respectively; that of blood was 17.8 HU. The SNR of DCB in 1 mM FeSO4 solution increased and achieved equilibrium at 120 min, and was 120.5 and higher than in the other FeSO4 solutions. The SNR of blood was 49.7. CONCLUSION: Optimally Fe2+-loaded DCBs can be discriminated from venous blood on 40-keV monochromatic images from DECT and T1-GRE.