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Abdominal Radiology (New York) Dec 2023PET/MRI is a relatively new imaging modality with several advantages over PET/CT that promise to improve imaging of the abdomen and pelvis for specific diagnostic tasks... (Review)
Review
PET/MRI is a relatively new imaging modality with several advantages over PET/CT that promise to improve imaging of the abdomen and pelvis for specific diagnostic tasks by combining the superior soft tissue characterization of MRI with the functional information acquired from PET. PET/MRI has an established role in staging and response assessment of multiple abdominopelvic malignancies, but the modality is not yet established for non-oncologic conditions of the abdomen and pelvis. In this review, potential applications of PET/MRI for non-oncologic conditions of abdomen and pelvis are outlined, and the available literature is reviewed to highlight promising areas for further research and translation into clinical practice.
Topics: Humans; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Neoplasms; Abdomen; Magnetic Resonance Imaging; Pelvis
PubMed: 37145312
DOI: 10.1007/s00261-023-03922-0 -
International Journal of Molecular... Dec 2023Pre-eclampsia (PE) continues to be a leading cause of maternal and fetal mortality and morbidity. While substantial progress has been made in understanding the... (Review)
Review
Pre-eclampsia (PE) continues to be a leading cause of maternal and fetal mortality and morbidity. While substantial progress has been made in understanding the pathomechanisms of PE, the pathophysiology of the disease is still not fully understood. While the "two-stage model" of the development of PE is the most widely accepted theory, stating that the placenta is the main source of the disease, there are some other pathophysiological models of PE. Among these other theories, the one considering heart dysfunction as serving as the primary cause of PE seems to be gaining increasing prominence. In this review, we aim to elucidate these two divergent concepts concerning the development of PE. Despite some differences in their proposed pathomechanisms, both theories share vital pathophysiological elements in common. A central and critical component in both models is impaired placental perfusion, which appears to be a crucial phenomenon in PE. A comprehensive understanding of the different pathomechanisms involved in PE may be helpful in clinical practice, prompting a more individual approach to care of patients with PE.
Topics: Female; Pregnancy; Humans; Placenta; Pre-Eclampsia; Family; Pelvis; Perfusion
PubMed: 38203478
DOI: 10.3390/ijms25010307 -
Archives of Gynecology and Obstetrics Dec 2023
Topics: Female; Humans; Pregnancy; Lipoma; Pelvis; Placenta
PubMed: 37052676
DOI: 10.1007/s00404-023-07039-z -
Abdominal Radiology (New York) Apr 2024Gynecological malignancies, such as ovarian cancers, cervical cancers, and endometrial cancers, have a significant global impact. Women with gynecologic malignancies may... (Review)
Review
Gynecological malignancies, such as ovarian cancers, cervical cancers, and endometrial cancers, have a significant global impact. Women with gynecologic malignancies may receive a single or a combination of treatments, including surgery, chemotherapy, and radiation-based therapies. Radiologists utilize various diagnostic imaging modalities to provide the surgeon with relevant information about the diagnosis, prognosis, optimal surgical strategy, and prospective post-treatment imaging. Computerized Tomography (CT) and magnetic resonance imaging (MRI) may be used initially to evaluate and detect post-treatment complications. Although CT is primarily used for staging, MRI is commonly used for a more accurate evaluation of a tumor's size and detection of local invasion. Complications such as hematoma, abscess, inclusion cyst, seroma, tumor thrombosis, anorectovaginal fistula, and gossypiboma may occur after the three primary treatments, and systems such as the genitourinary, gastrointestinal, neurological, and musculoskeletal may be affected. In order to distinguish between early-onset and late-onset complications following gynecological treatment, radiological findings of the most common post-treatment complications will be presented in this review.
Topics: Female; Humans; Genital Neoplasms, Female; Prospective Studies; Tomography, X-Ray Computed; Magnetic Resonance Imaging; Pelvis
PubMed: 38340181
DOI: 10.1007/s00261-023-04163-x -
Journal of Biomechanical Engineering Jun 2024Childbirth or labor, as the final phase of a pregnancy, is a biomechanical process that delivers the fetus from the uterus. It mainly involves two important biological...
Childbirth or labor, as the final phase of a pregnancy, is a biomechanical process that delivers the fetus from the uterus. It mainly involves two important biological structures in the mother, the uterus-generating the pushing force on the fetus-and the pelvis (bony pelvis and pelvic floor muscles)-resisting the movement of the fetus. The existing computational models developed in this field that simulate the childbirth process have focused on either the uterine expulsion force or the resistive structures of the pelvis, not both. An FEM model including both structures as a system was developed in this paper to simulate the fetus delivery process in LS-DYNA. Uterine active contraction was driven by contractile fiber elements using the Hill material model. The passive portion of the uterus and pelvic floor muscles were modeled with Neo Hookean and Mooney-Rivlin materials, respectively. The bony pelvis was modeled as a rigid body. The fetus was divided into three components: the head, neck, and body. Three uterine active contraction cycles were modeled. The model system was validated based on multiple outputs from the model, including the stress distribution within the uterus, the maximum Von Mises and principal stress on the pelvic floor muscles, the duration of the second stage of the labor, and the movement of the fetus. The developed model system can be applied to investigate the effects of pathomechanics related to labor, such as pelvic floor disorders and brachial plexus injury.
Topics: Pregnancy; Female; Humans; Biomechanical Phenomena; Parturition; Computer Simulation; Pelvis; Mechanical Phenomena; Finite Element Analysis
PubMed: 38299474
DOI: 10.1115/1.4064594 -
Current Opinion in Pediatrics Feb 2024The pelvis and hip account for 0.3--4% of fractures of the immature skeleton, and generally result from high energy trauma. These fractures range in severity from... (Review)
Review
PURPOSE OF REVIEW
The pelvis and hip account for 0.3--4% of fractures of the immature skeleton, and generally result from high energy trauma. These fractures range in severity from apophyseal avulsions to complete disruptions of the pelvic ring. The purpose of this article is to review the presentation, diagnosis, treatment and complications of these injuries in order to inform clinicians involved in their management. There is a lack of evidence-based management protocols for fractures of the immature pelvis largely due to their rarity and lack of robust scientific literature on the topic.
RECENT FINDINGS
Computed tomography/MRI is essential as up to 30% of pelvis and 70% of acetabular fractures are not identified on initial radiographs. A sub-optimal outcome is common in unstable fractures treated conservatively and adequate reduction and surgical stabilization is often required to avoid long-term morbidity.
SUMMARY
A coordinated approach involves resuscitation and temporary stabilization with planned definitive fixation. It is generally accepted that these injures should be managed in paediatric trauma centres. Whilst injuries vary in pattern and severity, we present an overview that considers the evaluation and treatment of the paediatric patient with pelvic and hip fractures to ensure that these injuries are identified promptly and treated by surgeons familiar with contemporary management algorithms.
Topics: Humans; Child; Pelvic Bones; Fractures, Bone; Pelvis; Radiography; Tomography, X-Ray Computed; Retrospective Studies
PubMed: 37851057
DOI: 10.1097/MOP.0000000000001301 -
Gait & Posture Jul 2023Thirty percent of adults in the United States use wearable fitness devices as of 2020 [1], such as fitness watches, to monitor and track health and physical activity...
BACKGROUND
Thirty percent of adults in the United States use wearable fitness devices as of 2020 [1], such as fitness watches, to monitor and track health and physical activity parameters. Physical changes during pregnancy may impact wrist worn device accuracy. The arms may be needed as compensation during walking because thorax axial rotation may be inhibited by pelvic tilt during pregnancy [2].
METHODS
To examine arm motion changes, twenty-three pregnant women (28 ± 4 y) were tested in four-week intervals ( ± 2 weeks) at 18-, 22-, 26-, 30- and 34-weeks' gestation. Kinematic data were measured during self-selected speed walking. Segment angles and angular velocities were analyzed over time. Linear regressions were used to analyze the correlations between arm motion and the other kinematic variables.
RESULTS
Arm range of motion significantly increased (p = 0.006) over gestation, but leg, thorax, and pelvis range of motions did not significantly change. Arm range of motion was correlated with pelvis (r =0.311, p = 0.001, β = 1.724) and leg (r = 0.285, p = 0.004, β = 1.520) range of motion and gait velocity (r =0.566, p = 0.001, β = 39.110). Arm velocities significantly increased (p < 0.012), as did leg velocities (p < 0.022) over gestation time, but thorax and pelvis rotational velocities did not significantly change over time. Arm velocity was correlated with leg velocity in both flexion (r =0.598, p = 0.001, β = 1.61) and extension (r =0.568, p = 0.001, β = 1.35).
SIGNIFICANCE
Arm swing increases over the course of gestation during walking, which does not follow the exact pattern of changes seen in the legs, thorax, and pelvis. These results show that a typical gait analysis of lower body motions may miss important biomechanical changes or compensations at different points over pregnancy. Future studies should examine why these changes may occur. Studies should also be conducted to see if arm changes impact outcome parameters from fitness watches and affect their validity as an exercise tracker during pregnancy.
Topics: Adult; Female; Humans; Pregnancy; Biomechanical Phenomena; Gait; Walking; Pelvis; Rotation; Arm; Range of Motion, Articular
PubMed: 37356228
DOI: 10.1016/j.gaitpost.2023.06.017 -
Radiation Protection Dosimetry Feb 2024Projection radiography is the most common radiological modality, and radiation safety of it concerns both radiation workers and the public. We measured and generated a...
Projection radiography is the most common radiological modality, and radiation safety of it concerns both radiation workers and the public. We measured and generated a series of scattered radiation maps for projection radiography and estimated effective doses of the supporting person during exposure. Measured adult patient protocols included chest posterior-anterior, chest lateral, pelvis anterior-posterior (AP), abdomen AP and bedside chest AP. Maps concretise spatial distribution and the scattered radiation dose rates in different imaging protocols. Highest and lowest rates were measured in abdomen AP and bedside chest AP protocols, respectively. The effective dose of supporting person in abdomen AP examination at distance of 0.5 m was 300 nSv and in bedside supine chest AP examination at distance of 0.7 m was 0.5 nSv. The estimated annual effective dose of emergency unit radiographer was 0.11 mSv. The obtained effective dose values are small compared to annual dose limits of radiation workers and the public.
Topics: Adult; Humans; X-Rays; Radiation Dosage; Radiography; Pelvis; Physical Examination; Radiography, Thoracic
PubMed: 37939724
DOI: 10.1093/rpd/ncad275 -
Nature Communications Oct 2023Traditional total mesorectal excision (TME) for rectal cancer requires partial resection of Denonvilliers' fascia (DVF), which leads to injury of pelvic autonomic nerve... (Randomized Controlled Trial)
Randomized Controlled Trial
Traditional total mesorectal excision (TME) for rectal cancer requires partial resection of Denonvilliers' fascia (DVF), which leads to injury of pelvic autonomic nerve and postoperative urogenital dysfunction. It is still unclear whether entire preservation of DVF has better urogenital function and comparable oncological outcomes. We conducted a randomized clinical trial to investigate the superiority of DVF preservation over resection (NCT02435758). A total of 262 eligible male patients were randomized to Laparoscopic TME with DVF preservation (L-DVF-P group) or resection procedures (L-DVF-R group), 242 of which completed the study, including 122 cases of L-DVF-P and 120 cases of L-DVF-R. The initial analysis of the primary outcomes of urogenital function has previously been reported. Here, the updated analysis and secondary outcomes including 3-year survival (OS), 3-year disease-free survival (DFS), and recurrence rate between the two groups are reported for the modified intention-to-treat analysis, revealing no significant difference. In conclusion, L-DVF-P reveals better postoperative urogenital function and comparable oncological outcomes for male rectal cancer patients.
Topics: Humans; Male; Follow-Up Studies; Rectal Neoplasms; Pelvis; Autonomic Pathways; Fascia
PubMed: 37863878
DOI: 10.1038/s41467-023-42367-3 -
Journal of Medical Radiation Sciences Jun 2024Concerns regarding the adverse consequences of radiation have increased due to the expanded application of computed tomography (CT) in medical practice. Certain studies...
Introducing fitting models for estimating age-specific dose and effective dose in paediatric patients undergoing head, chest and abdomen-pelvis imaging protocols: a patient study.
INTRODUCTION
Concerns regarding the adverse consequences of radiation have increased due to the expanded application of computed tomography (CT) in medical practice. Certain studies have indicated that the radiation dosage depends on the anatomical region, the imaging technique employed and patient-specific variables. The aim of this study is to present fitting models for the estimation of age-specific dose estimates (ASDE), in the same direction of size-specific dose estimates, and effective doses based on patient age, gender and the type of CT examination used in paediatric head, chest and abdomen-pelvis imaging.
METHODS
A total of 583 paediatric patients were included in the study. Radiometric data were gathered from DICOM files. The patients were categorised into five distinct groups (under 15 years of age), and the effective dose, organ dose and ASDE were computed for the CT examinations involving the head, chest and abdomen-pelvis. Finally, the best fitting models were presented for estimation of ASDE and effective doses based on patient age, gender and the type of examination.
RESULTS
The ASDE in head, chest, and abdomen-pelvis CT examinations increases with increasing age. As age increases, the effective dose in head and abdomen-pelvis CT scans decreased. However, for chest scans, the effective dose initially showed a decreasing trend until the first year of life; after that, it increases in correlation with age.
CONCLUSIONS
Based on the presented fitting model for the ASDE, these CT scan quantities depend on factors such as patient age and the type of CT examination. For the effective dose, the gender was also included in the fitting model. By utilising the information about the scan type, region and age, it becomes feasible to estimate the ASDE and effective dose using the models provided in this study.
Topics: Humans; Child; Radiation Dosage; Female; Male; Adolescent; Child, Preschool; Infant; Tomography, X-Ray Computed; Head; Pelvis; Abdomen; Thorax; Age Factors; Infant, Newborn; Radiography, Thoracic; Radiography, Abdominal
PubMed: 38454637
DOI: 10.1002/jmrs.772