Goal:The aim of the study is to define the MRI appearance of disorder in the Junctional zone (JZ) in women with adenomyosis compared to those without it, given the importance of the JZ in the regulation of various reproductive events.Materials and methods:This was a prospective, comparative and open study. Patients with adenomyosis have been sorted in target group, n = 82, while the control group consisted of patients without adenomyosis, n = 82. All patients, from both groups have undergone a magnetic resonance imaging of the pelvis. Using a software tool for measurement, the thickness of the JZ was measured in T2w sag sequences in all patients from both groups (target and control) n = 164. Patients in the target group type adenomyosis were assessed and categorized either as: diffuse, focal, or Adenomyoma and the results were compared. The presence of endometriosis and myomas in both groups was evaluated and its coexistence with adenomyosis was analyzed as well.Results:Of the 82 patients in the target group, 81.7% of the patients had diffuse adenomyosis, while 18.3% had focal type with statistically significant difference (p <0.05). The results of the Mann-Whitney U test showed that p <0.05, implying that there is a statistically significant difference in the thickness of the JZ between the control and target group, therefore patients from the target group with adenomyosis had a statistically significantly thicker junctional zone than the patients in the control group. The JZ in the target group was on average M = 14,3mm, SD = 1.3mm, while the thickness of JZ in the control group without adenomyosis was M = 5,6mm, SD = 1,3. Chi-square shows that p <0.05, implying that there is a statistically significant difference in the number of patients with myomas between the two groups, where the myomas significantly over-represented in the target group with 32,9 % vs.6 %).Conclusion:MRI is the method of choice for imaging and evaluation of JZ as an important diagnostic marker in the diagnosis of adenomyosis. It is important to recognize this condition as early as possible and distinguish it from other pathologies in order for timely and appropriate treatment.
Objectives:The aim of this study was to determine sensitivity, specificity, and predictive values of sonographically demonstrated ureteral dilatation in detecting vesicoureteral reflux (VUR).Methods:Ethical approval from the Ethical Committee of Clinical Center University of Sarajevo and parental consent were obtained for this prospective study involving 120 children with history of urinary tract infections (UTIs). Ultrasound examination included the evaluation of the urinary tract, with a special emphasis on evaluation of ureteral dilatation. Voiding urosonography (VUS) was carried out according to a standard protocol with the use of ultrasound contrast agent Sono Vue of second generation. Ureteral diameter greater than 3 mm was considered pathological. Proven VUR was graded into one of three stages.Results:Infectio tracti urinarii recidivans was referral diagnosis in the majority of patients. The average age of patients was 4.33 ± 3.88 years (from 2 months to 16 years of age). VUS findings were normal in 59 (49.2%), and pathological in 61 (50.8%) patients. Statistical analysis showed significant correlation between type and grade of VUR. Our data confirmed predominance of VUR in females and in children under the age of 5. Statistically significant correlation between ureteral dilatation and the existence of VUR was found, with relatively high sensitivity (67.2%), specificity (81.4%), and high positive (78.8%) and negative predictive value (70.6%), total diagnostic accuracy of 74.2% in detecting VUR, and significantly increased probability (20 – 25%) of detecting VUR in patients with sonographically confirmed ureteral dilatation.Conclusion:Sonographically confirmed ureteral dilatation can be used as a predictor of VUR in children with UTIs, and in combination with other predictors, might find a place in an evidence-based selective strategy in children with suspected VUR.
Ultrasound devices and methodologies have been continuously evolving and becoming more important as tools in diagnostic medicine. Recently a new ultrasound diagnostic technique has been developed. Named sonoelastography, the technique enables evaluation of tissue elasticity and is based on differences in stiffness (hardness, compressibility, elasticity) of pathological changes and normal adjacent tissue. Sonoelastography (SE) is also known as Real-time tissue elastography (RTE), Real-time sonoelastography (RTSE), Tissue type imaging (TTI) and Ultrasound Strain Imaging Technology. It has been found useful in many medicine elds and adopted readily by clinicians of different specialties. It gives more information than conventional ultrasound in evaluation of tumors, liver disease, skeletal muscles, rheumatoid nodules and other pathological changes. This review covers the basics of elastography, its applications, instruments, techniques, the scoring system and the indications for elastography.
Liver injuries caused by high voltage electricity are rare and result in high mortality and morbidity. They are produced by the resistance to the passage of electrical current through the tissue, which creates heat that leads to coagulation necrosis and rupture of the cell membrane. We present a case of an electrical injury to the liver, diagnosed by ultrasound and CT in a 39-year-old man who presented with skin burns on his right hand and right hemiabdomen. Injuries occurred after the contact with 220 kV high voltage electricity.
To evaluate possibilities of computed tomography (CT) perfusion in differentiation of solitary focal liver lesions based on their characteristic vascularization through perfusion parameters analysis.
In the case of renal artery aneurysm that we founded we recommended regular Color Doppler ultrasound examinations, consultation from the urologist and CTA control if there is a need.
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