Adenomyosis is a challenging clinical condition that is commonly being diagnosed in women of reproductive age. To date, many aspects of the disease have not been fully understood, making management increasingly difficult. Over time, minimally invasive diagnostic and treatment methods have developed as more women desire uterine preservation for future fertility or to avoid major surgery. Several uterine-sparing treatment options are now available, including medication, hysteroscopic resection or ablation, conservative surgical methods, and high-intensity focused ultrasound each with its own risks and benefits. Uterine artery embolization is an established treatment option for uterine fibroids and has recently gained ground as a safe and cost-effective method for treatment of uterine adenomyosis with promising results. In this review, we discuss current trends in the management of uterine adenomyosis with a special focus on uterine artery embolization as an alternative to hysterectomy.

No abstract

Objectives: To set age-specific normal reference values for brainstem, cerebellar vermis, and peduncles measurements and characterize values’ variations according to gender, age, and age by gender interaction. Methods: 565 normal brain magnetic resonance examinations with normal anatomy and signal intensity of the supra and infratentorial structures were categorized into six age groups (infant, child, adolescent, young adult, middle-age adult, and old aged adults). Patients with congenital malformations, gross pathology of the supra or infratentorial brain, brain volume loss, developmental delay, metabolic disorders, and neuropsychological disorders (n = 2.839) were excluded. On midsagittal T1-weighted and axial T2-weighted images specific linear diameters and ratios of the brainstem, cerebellar vermis, and peduncles were attained. Two observers assessed a random sample of 100 subjects to evaluate the inter- and intra observer reproducibility. Intraclass correlation coefficients (ICCs), means ± standard deviation (SD), one, and two-way analysis of variance tests were used in the statistical analysis. Results: Good to excellent inter- and intra observer measurements’ reproducibility were observed, except for the transverse diameter of the midbrain, the anteroposterior diameter of the medulla oblongata at the pontomedullary and cervicomedullary junctions, cerebellar vermis anteroposterior diameter, and thickness of the superior cerebellar peduncle. Age-specific mean values of the investigated measurements were established. A significant gender-related variation was recorded in the anteroposterior diameter of the basis pontis (p = 0.044), the anteroposterior diameter of the medulla oblongata at the cervicomedullary junction (p = 0.044), and cerebellar vermis height (p = 0.018). A significant age-related change was detected in all measurements except the tectal ratio. Age by gender interaction had a statistically significant effect on the tectal ratio, inferior, and middle cerebellar peduncles’ thickness (p = 0.001, 0.022, 0.028, respectively). Conclusion: This study provides age-specific normal mean values for various linear dimensions and ratios of the posterior fossa structures with documentation of measurements’ variability according to gender, age, and their interaction. Advances in knowledge: It provides a valuable reference in the clinical practice for easier differentiation between physiological and pathological conditions of the posterior fossa structures especially various neurodegenerative diseases and congenital anomalies.

No abstract

Background: The major imaging method for early diagnosis of breast cancer is screening mammography. One and half to four years before a malignancy becomes clinically apparent, mammography may identify it. Faster scanning times in the mammography suite are possible with contrast-enhanced spectral mammography. Clinical effectiveness of contrastenhanced spectral mammography for detecting asymmetry in mammograms was assessed in this study. Objective: Assessment of possible role of contrast-enhanced spectral mammography for diagnosing breast asymmetry. Methods: Breast asymmetry, and contrast-enhanced spectral mammography were all looked for in PubMed, Google scholar, and Science direct. References from relevant literature were also evaluated by the authors, but only the most recent or complete study from March 2006 to April 2021 was included. Due to the lack of sources for translation, documents in languages other than English were ruled out. Papers that did not fall under the purview of major scientific investigations, such as unpublished manuscripts, oral presentations, conference abstracts, and dissertations, were omitted. Conclusion: Especially for women with dense breasts, contrast-enhanced spectral mammography has the potential to be effective in identifying lesions that would otherwise go undetected due to breast asymmetry. This would improve the rate at which breast cancer is detected in its earliest stages.

Background: The common and potentially fatal disorder known as coronary artery disease (CAD) is characterised by turbulent and sluggish blood flow at the coronary artery bifurcation site, particularly at broader angles. Curved multiplanar reformat (CMPR) and 3D volume rendering (3D VR) techniques could help in prediction of CAD. Objective: The aim of the current study was to evaluate of the capability of Multi-detector CT (MDCT) coronary angiography to quantify coronary bifurcation angles for early preventative treatment or preprocedural planning for coronary intervention. Patients and methods: Using a 128-detectors scanner, 60 patients with typical or atypical chest discomfort or failed catheterization received MDCT coronary angiography to characterise coronary anatomy. Coronary bifurcation angles were calculated using specialised software and post-processing methods for correlation with CAD severity. Results: Compared to the 3D VR approach, the CMPR technique revealed wider values of coronary bifurcation angles. However, Bland-Altman plots showed that both methods may be alternatively used. Because a wider angle was linked to a greater degree of stenosis, LAD-LCX angle differed significantly between individuals with significant and nonsignificant CAD. Conclusion: Measurements of various coronary bifurcation angles, particularly the LAD-LCX angle, which is thought to be a predictor for CAD, can be made using MDCT coronary angiographic examination with CMPR and 3D VR methods. More plaques are likely to form when the angle is wider.

No abstract

No abstract