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BioMed Research International 2018Uterine fibroids are the most common benign pelvic tumor of the female genital tract and tend to increase with age; they cause menorrhagia, dysmenorrhea, pelvic pressure... (Review)
Review
Uterine fibroids are the most common benign pelvic tumor of the female genital tract and tend to increase with age; they cause menorrhagia, dysmenorrhea, pelvic pressure symptoms, back pain, and subfertility. Currently, the management is based mainly on medical or surgical approaches. The nonsurgical and minimally invasive therapies are emerging approaches that to the state of the art include uterine artery embolization (UAE), image-guided thermal ablation techniques like magnetic resonance-guided focused ultrasound surgery (MRgFUS) or radiofrequency ablation (RF), and percutaneous microwave ablation (PMWA). The purpose of the present review is to describe feasibility results and safety of PMWA according to largest studies available in current literature. Moreover technical aspects of the procedure were analyzed providing important data on large scale about potential efficacy of PMWA in clinical setting. However larger studies with international registries and randomized, prospective trials are still needed to better demonstrate the expanding benefits of PMWA in the management of uterine fibroids.
Topics: Female; Humans; Leiomyoma; Magnetic Resonance Imaging; Microwaves; Pelvic Neoplasms; Pelvis; Radiofrequency Therapy; Radiotherapy, Image-Guided; Treatment Outcome; Uterine Artery Embolization
PubMed: 29511672
DOI: 10.1155/2018/2360107 -
Anatomical Record (Hoboken, N.J. : 2007) Mar 2021The ontogeny of the paired appendages has been extensively studied in lungfishes and tetrapods, but remains poorly known in coelacanths. Recent work has shed light on...
The ontogeny of the paired appendages has been extensively studied in lungfishes and tetrapods, but remains poorly known in coelacanths. Recent work has shed light on the anatomy and development of the pectoral fin in Latimeria chalumnae. Yet, information on the development of the pelvic fin and girdle is still lacking. Here, we described the development of the pelvic fin and girdle in Latimeria chalumnae based on 3D reconstructions generated from conventional and X-ray synchrotron microtomography, as well as MRI acquisitions. As in other jawed vertebrates, the development of the pelvic fin occurs later than that of the pectoral fin in Latimeria. Many elements of the endoskeleton are not yet formed at the earliest stage sampled. The four mesomeres are already formed in the fetus, but only the most proximal radial elements (preaxial radial 0-1) are formed and individualized at this stage. We suggest that all the preaxial radial elements in the pelvic and pectoral fin of Latimeria are formed through the fragmentation of the mesomeres. We document the progressive ossification of the pelvic girdle, and the presence of a trabecular system in the adult. This trabecular system likely reinforces the cartilaginous girdle to resist the muscle forces exerted during locomotion. Finally, the presence of a preaxial element in contact with the pelvic girdle from the earliest stage of development onward questions the mono-basal condition of the pelvic fin in Latimeria. However, the particular shape of the mesomeres may explain the presence of this element in contact with the girdle.
Topics: Animal Fins; Animals; Biological Evolution; Fishes; Fossils; Magnetic Resonance Imaging; Pelvis; Phylogeny
PubMed: 32445538
DOI: 10.1002/ar.24452 -
Journal of Digital Imaging Dec 2022The rotation and tilt of the pelvis during anteroposterior pelvic radiography can lead to misdiagnosis of developmental dysplasia of the hip (DDH) in children. At... (Randomized Controlled Trial)
Randomized Controlled Trial
The rotation and tilt of the pelvis during anteroposterior pelvic radiography can lead to misdiagnosis of developmental dysplasia of the hip (DDH) in children. At present, no method exists for accurately and conveniently measuring the precise rotation and tilt angles of pelvic on radiographs. The objective of this study was to develop several rotation and tilt measurement models using transfer learning and digital reconstructed radiographs (DRRs), and to compare their performances on pelvic radiographs. Based on the inclusion criteria, 30 of 92 children who underwent 3D hip CT scans at Xijing Hospital from 2015 to 2020 were included in the study. Using DRR techniques, radiographs were generated by rotating and tilting the pelvis in CT datasets at - 12 to 12° (projected every 3°) and were randomized to a 2:1:1 ratio of training dataset, validation dataset, and test dataset. Five pre-trained networks, including VGG16, Xception, VGG19, ResNet50 and InceptionV3 were used to develop pelvic rotation measurement models and tilt measurement models, and these models were trained with training dataset. The callback function was used during the training to slow down the learning rate when learning was stalled. Then, the validation set was used to optimize each model and compare their performances. At last, we tested the final performances of optimal rotation measurement model and optimal tilt measurement model on test dataset. The mean absolute error (MAE) was employed to assess the performance of the models. A total of 2430 pelvic DRRs were collected based on 30 CT datasets. Among 5 pre-trained transfer learning models, VGG16-Tilt achieved the best tilt prediction performance at the same BS and different LR. VGG16-Tilt model achieved its best performance on validation set at LR = 0.001 and BS = 4, and the final MAE on the test set was 0.5250°. In terms of rotation prediction, VGG16-Rotation also achieved the best performance, and it achieved its best performance on validation set at LR = 0.002 and BS = 8. The final MAE of VGG16-Rotation on the test set was 1.0731°. Pretrained transfer learning models worked well in predicting tilt and rotation angles of the pelvis on radiographs in children. Among them, VGG16-Tilt and VGG16-Rotation had the best effect in dealing with such problems despite their simple structures. These models deployed in devices can give orthopedic surgeons a powerful aid in DDH diagnosis.
Topics: Child; Humans; Rotation; Radiography; Pelvis; Diagnostic Errors; Machine Learning
PubMed: 35711070
DOI: 10.1007/s10278-022-00672-1 -
Orthopaedic Surgery Oct 2022Evaluation of sagittal pelvic tilt is significant for hip surgeons. However, the accurate measurement of pelvic sagittal inclination (PSI) is still a challenge. The...
OBJECTIVE
Evaluation of sagittal pelvic tilt is significant for hip surgeons. However, the accurate measurement of pelvic sagittal inclination (PSI) is still a challenge. The objective of this study is to propose a new method for measurement of PSI from pelvic anteroposterior radiograph based on the inverse cosine function obtained from individualized pelvic model.
METHODS
Collecting the imaging data of 30 patients with both pelvic CT and full-length spine radiographs. Establishing pelvic model by customized 3D reconstruction software. The length of three groups of longitudinal and transverse line segments (A'p and B') were measured from full-length spine anteroposterior radiographs. The corresponding anatomical parameters, including A, B, b, ∠α, ∠γ, were measured and calculated on the same patient's pelvic model. The estimated PSI (ePSI) based on three groups of anatomical landmarks, including ePSI-1, ePSI-2, and ePSI-3, were calculated by equation, , and compared with the actual PSI (aPSI) measured by Surgamap software. For the reliability and validation evaluation, three observers measured these parameters in two rounds. Intra-class correlation and inter-class correlation were both calculated. Bland-Altman method was used to evaluate the consistency between the estimated PSI (ePSI) and the actual PSI (aPSI).
RESULTS
ePSI-1 and ePSI-2 showed excellent intra-observer reliability (0.921-0.997, p < 0.001) and inter-observer reliability (0.801-0.977, p < 0.001). ePSI-3 had a fair inter-observer reliability (0.239-0.823, p < 0.001). ePSI-1 showed the strongest correlation with aPSI (r = 0.917, p < 0.001). Mean (maximum) absolute difference of ePSI-1, ePSI-2, and ePSI-3 is 2.62° (7.42°), 4.23° (13.78°), and 7.74° (31.47°), respectively. The proportion of cases with absolute difference less than 5° in three groups were 86.7% (ePSI-1), 66.7% (ePSI-2), 56.7% (ePSI-3).
CONCLUSION
This new method based on inverse cosine function has good reliability and validity when used in the evaluation of PSI on pelvic anteroposterior radiographs.
Topics: Humans; Manipulation, Orthopedic; Pelvis; Posture; Radiography; Reproducibility of Results
PubMed: 36102214
DOI: 10.1111/os.13488 -
Medicine Feb 2022In malalignment syndrome, the spino-pelvic alignment correction with foot orthotics can be applied only to a standing position in the coronal plane. Considering the fact... (Comparative Study)
Comparative Study
In malalignment syndrome, the spino-pelvic alignment correction with foot orthotics can be applied only to a standing position in the coronal plane. Considering the fact that the average time Koreans spend sitting in a chair is 7.5 hours per day, studies on spino-pelvic correction in sitting position is needed. The purpose of this study is to investigate the pressure changes and radiographic assessment of spino-pelvic alignment using a chair equipped with a height-adjustable seat-plate. This study was conducted on 30 participants with spinopelvic malalignment. All participants were subjected to measure buttocks interface pressure while seated using a smart chair in three consecutive steps: 1. on initial seated, 2. on balancing seated, and then. 3. on 1 hour balancing seated. Radiographically, the five spino-pelvic parameters such as shoulder height differences (SHD), iliac crest height differences (ICHD), leg length discrepancy (LLD), pelvic oblique angle (POA), and coronal imbalance were analyzed to investigate the effect of pelvic imbalance compensation on spino-pelvic alignment. Statistical analysis was performed using ANOVA and paired test. The pressure discrepancy improvement between buttocks from 36.4 ± 32.3 mm on initial seated to 15.7 ± 20.3 mm on balancing, 12.7 ± 10.9 mm on 1hr balancing seated (Ω, ). The radiographic results of pelvic imbalance compensation during seated show a statistical improvement of average SHD (from −0.9 to −0.8 mm, = .005) and average ICHD (from 9.5 to 2.5 mm, = .037). For a standing posture after use of smart chair, average SHD value (−3.0 to −1.0 mm, = .005), ICHD (from 1.8 to 0.8 mm, = .016), and average LLD value (0.8–0.1 mm, = .033) were statistically significant improved. Spine-pelvic malalignment can be improved by individually customized pelvic compensation using balanced seat plate height adjustments under the real-time pressure sensing and monitoring on the buttocks while seated.
Topics: Buttocks; Humans; Ischium; Lumbar Vertebrae; Pelvis; Postural Balance; Pressure; Radiography; Sitting Position; Spine; Standing Position
PubMed: 35119044
DOI: 10.1097/MD.0000000000028783 -
World Journal of Surgical Oncology Feb 2023Due to the fixed bony structure of the pelvis, the pelvic operation space is limited, complicating the surgical operation of rectal cancer, especially middle and low... (Review)
Review
Due to the fixed bony structure of the pelvis, the pelvic operation space is limited, complicating the surgical operation of rectal cancer, especially middle and low rectal cancer. The closer the tumor is to the anal verge, the smaller the operative field and operating space, the longer the operative time, and the greater the incidence of intraoperative side injuries and postoperative complications. To date, there is still no clear definition of a difficult pelvis that affects the surgical operation of rectal cancer. Few related research reports exist in the literature, and views on this aspect are not the same between countries. Therefore, it is particularly important to predict the difficulty of rectal cancer surgery in a certain way before surgery and to select the surgical method most suitable for each case during the treatment of rectal cancer.
Topics: Humans; Laparoscopy; Pelvis; Rectal Neoplasms; Rectum; Anal Canal; Treatment Outcome
PubMed: 36843078
DOI: 10.1186/s12957-023-02933-x -
Scientific Reports Jun 2023Previous research on the effects of body mass on the pelvic girdle focused mostly on adult females and males. Because the ontogenetic plasticity level in the pelvis...
Previous research on the effects of body mass on the pelvic girdle focused mostly on adult females and males. Because the ontogenetic plasticity level in the pelvis remains largely unknown, this study investigated how the association between body mass index (BMI) and pelvic shape changes during development. It also assessed how the large variation in pelvic shape could be explained by the number of live births in females. Data included CT scans of 308 humans from infancy to late adulthood with known age, sex, body mass, body stature, and the number of live births (for adult females). 3D reconstruction and geometric morphometrics was used to analyze pelvic shape. Multivariate regression showed a significant association between BMI and pelvic shape in young females and old males. The association between the number of live births and pelvic shape in females was not significant. Less plasticity in pelvic shape in adult females than during puberty, perhaps reflects adaptation to support the abdominopelvic organs and the fetus during pregnancy. Non-significant susceptibility to BMI in young males may reflect bone maturation accelerated by excessive body mass. Hormonal secretion and biomechanical loading associated with pregnancy may not have a long-term effect on the pelvic morphology of females.
Topics: Adult; Male; Pregnancy; Female; Humans; Infant; Pelvis; Lower Extremity; Body Mass Index; Body Size; Puberty
PubMed: 37322042
DOI: 10.1038/s41598-023-36703-2 -
Respiratory Physiology & Neurobiology Oct 2023The study aimed to identify whether pelvic floor muscles modulate length with breathing, and if any length changes induced by breathing relate to abdominal cavity...
The study aimed to identify whether pelvic floor muscles modulate length with breathing, and if any length changes induced by breathing relate to abdominal cavity displacement and intra-abdominal pressure. To investigate these relationships, displacement of pelvic landmarks that related to pelvic floor muscle length using transperineal ultrasound imaging, breath volume, intra-abdominal pressure, abdominal and ribcage displacement, and abdominal and anal sphincter muscle electromyography were measured during quiet breathing and breathing with increased dead-space in ten healthy men. Pelvic floor muscle landmark displacement modulated with ribcage motion during breathing. This relationship was stronger for: i) motion of the urethrovesical junction (puborectalis muscle length change) than the mid-urethra landmark (striated urethral sphincter muscle length change), and ii) dead-space breathing in standing than dead-space breathing in supine or quiet breathing in standing. In most (but not all) participants, the urethrovesical junction descended during inspiration and elevated during expiration. Striated urethral sphincter length changes during the respiratory cycle was independent of intra-abdominal pressure. In summary, breathing involves pelvic floor muscle length changes and is consistent with the role of these muscles during respiration to aid maintenance of continence, lung ventilation and/or provision of support to the abdominal cavity. Clinicians who train pelvic floor muscles need to be aware that length change of pelvic floor muscles is expected with breathing.
Topics: Male; Humans; Pelvic Floor; Perineum; Muscle Contraction; Muscle, Skeletal; Exhalation
PubMed: 37516287
DOI: 10.1016/j.resp.2023.104117 -
Cardiovascular and Interventional... Aug 2015Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with... (Review)
Review
Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with refluxing pelvic veins associated with leg varicosities are also being treated. A more unusual reason for PVE is to treat pelvic venous malformations, although such lesions may be treated with sclerotherapy alone. Embolotherapy for treating PVC has been performed for many years with several published studies included in this review, whilst an emerging indication for PVE is to treat lower limb varicosities associated with pelvic vein reflux. Neither group, however, has been subjected to an adequate randomized, controlled trial. Consequently, some of the information presented in this review should be considered anecdotal (level III evidence) at this stage, and a satisfactory 'proof' of clinical efficacy remains deficient until higher-level evidence is presented. Furthermore, a wide range of techniques not accepted by all are used, and some standardization will be required based on future mandatory prospective studies. Large studies have also clearly shown an unacceptably high recurrence rate of leg varicose veins following venous surgery. Furthermore, minimally or non-invasive imaging is now revealing that there is a refluxing pelvic venous source in a significant percentage of women with de novo leg varicose veins, and many more with recurrent varicosities. Considering that just over half the world's population is female and a significant number of women not only have pelvic venous reflux, but also have associated leg varicosities, minimally invasive treatment of pelvic venous incompetence will become a common procedure.
Topics: Embolization, Therapeutic; Female; Humans; Pelvic Pain; Pelvis; Radiography; Sclerotherapy; Treatment Outcome; Venous Insufficiency
PubMed: 25804635
DOI: 10.1007/s00270-015-1074-7 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2017The shift to habitual bipedalism 4-6 million years ago in the hominin lineage created a morphologically and functionally different human pelvis compared to our closest... (Review)
Review
The shift to habitual bipedalism 4-6 million years ago in the hominin lineage created a morphologically and functionally different human pelvis compared to our closest living relatives, the chimpanzees. Evolutionary changes to the shape of the pelvis were necessary for the transition to habitual bipedalism in humans. These changes in the bony anatomy resulted in an altered role of muscle function, influencing bipedal gait. Additionally, there are normal sex-specific variations in the pelvis as well as abnormal variations in the acetabulum. During gait, the pelvis moves in the three planes to produce smooth and efficient motion. Subtle sex-specific differences in these motions may facilitate economical gait despite differences in pelvic structure. The motions of the pelvis and hip may also be altered in the presence of abnormal acetabular structure, especially with acetabular dysplasia. Anat Rec, 300:633-642, 2017. © 2017 Wiley Periodicals, Inc.
Topics: Biological Evolution; Gait; Hip Joint; Humans; Pelvic Bones; Pelvis
PubMed: 28297184
DOI: 10.1002/ar.23552