Transvaginal Ultrasound for the Diagnosis of Adenomyosis: Systematic Review and Meta-Analysis.

Noninvasive Diagnosis of Adenomyosis: A Structured Review and Meta-analysis of Diagnostic Accuracy in Imaging.

Adenomyosis or endometriosis genitalis interna is a frequent benign disease of women in fertile age. It causes symptoms like bleeding disorders and dysmenorrhea and seems to have a negative effect on fertility. Adenomyosis can be part of a complex genital and extragenital endometriosis but also can be found as a solitary uterine disease. While peritoneal endometriosis can be easily diagnosed by laparoscopy with subsequent biopsy, the determination of adenomyosis is difficult. In the following literature review, the diagnostic methods clinical history and symptoms, gynecological examination, 2D and 3D transvaginal ultrasound, MRI, hysteroscopy, and laparoscopy will be discussed step by step in order to evaluate their predictive value in the diagnosis of adenomyosis.

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From Clinical Symptoms to MR Imaging: Diagnostic Steps in Adenomyosis

Leiomyoma is the most frequent benign monoclonal tumor (cells behave identically in culture) of the female reproductive system. It affected almost 50% of childbearing age women, deteriorating the quality of life and may cause infertility. The unique features of this pathology is the absence of detailed understanding of pathogenic mechanisms and continuous morbidity among any age groups. Despite the huge amount of articles and studies related to leiomyoma, review pretend to depict herein actual and non-trivial information. This review assemble a versatile description of medical and biological aspects of leiomyomas. Explanation of genetic, molecular, pathophysiological mechanisms of uterine fibroid growing predetermine marked clinical symptoms of pathology. Mentioned model systems show multivariation of leiomyomas in human and animals. Review gives an opportunity analyze separate facets and collect it in one deep understanding of leiomyomas.

http://cejsh.icm.edu.pl/cejsh/element/bwmeta1.element.oai-journals-pan-pl-87767/c/oai-journals-pan-pl-87767_full-text_187f6ea4-288a-4a8d-bb73-3c5b36519ca0.pdf

Uterine fibroid: common features of widespread tumor (Review article).

Objectives To evaluate the diagnostic accuracy of the classic ultrasound (US) signs of adenomyosis, the question mark sign and transvaginal ultrasound (TVUS) uterine tenderness, in the diagnosis of adenomyosis. Methods This was a prospective study including 78 patients waiting for hysterectomy for uterine benign diseases and undergoing preoperative US examinations to evaluate all criteria for US diagnosis of adenomyosis as reported by the consensus statement of the Morphological Uterus Sonographic Assessment group. A US diagnosis of adenomyosis was made in the presence of 2 or more Morphological Uterus Sonographic Assessment features. Moreover, the question mark sign and TVUS uterine tenderness were evaluated. Ultrasound features were compared with the histologic examination, which was considered the reference standard for the diagnosis of adenomyosis. The Cohen κ coefficient was used to measure the accordance between US and histologic results. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each US feature were calculated. Results The prevalence of adenomyosis in the sample was 33.3%. The sensitivity, specificity, PPV, NPV, and accuracy of TVUS in the diagnosis of adenomyosis were 77%, 96%, 91%, 89%, and 90%, respectively. Myometrial heterogeneity was the most frequently encountered feature (100%) but showed low specificity (7%). The question mark sign and TVUS uterine tenderness showed sensitivity, specificity, PPV, NPV, and accuracy of 41%, 96%, 83%, 77%, and 69% and 69%, 65%, 66%, 81%, and 67%. Conclusions The question mark sign and TVUS uterine tenderness are useful tools for the diagnosis of adenomyosis.

Question Mark Sign and Transvaginal Ultrasound Uterine Tenderness for the Diagnosis of Adenomyosis: A Prospective Validation.

Introduction
Adenomyosis and Leiomyoma are common disorders affecting females in their reproductive age. They mimic each other in clinical presentation. Due to similarities in clinical symptoms and signs, missing one diagnosis in favour of the other is not very uncommon. Accurate diagnosis of these two conditions is important for their management. In this study we evaluated role of 3D Ultrasound and Doppler in differentiating clinically suspected cases of leiomyoma and adenomyosis of uterus.

Role of 3D Ultrasound and Doppler in Differentiating Clinically Suspected Cases of Leiomyoma and Adenomyosis of Uterus.

Intracranial lipomas are rare congenital, non-neoplastic lesions discovered incidentally on computerised tomography (CT) or magnetic resonance imaging (MRI) with an incidence rate of less than 0.1% of all intracranial tumours. Most lipomas are asymptomatic pericallosal lesions sometimes presenting with seizures or headache. Corpus callosum agenesis and defects of midline structures differentiation may be present. Callosal lipomas are of two types: Anterior bulky tubulonodular variety associated with forebrain and rostral callosal anomalies, and posterior ribbon-like curvilinear lipoma generally seen with a normal or near normal corpus callosum. Corpus callosal hypogenesis/agenesis is seen in up to 90% of anterior and 30% of posterior pericallosal lipomas. The association of corpus callosal lipoma with choroid plexus lipoma is variable with its reported incidence rate being 20-50%. A 50-year-old patient was referred to our department for CT scan of brain with history of recent onset of headache and one episode of seizure. We present the imaging findings in this rare case of callosal tubulonodular lipoma having prominent intralesional vessels and extensive calcification with a concomitant intraventricular lipoma in a patient with dysgenetic corpus callosum.

Multiple intracranial lipoma

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Incidence and distribution of normal intracranial calcifications in adults on computed tomography.

Pathological basal ganglia calcification can be due to various causes such as metabolic disorders, infections and genetic diseases. Hypoparathyroidism is one of the most common causes of pathological basal ganglia calcification. However, the presence of extensive intracranial calcifications involving other areas of the brain is uncommon. Patients with hypoparathyroidism can present with neurological symptoms related to hypocalcemia, extrapyramidal signs and seizures. We report the case of a young adult who presented with seizures, signs of cerebellar involvement and extensive intracranial calcifications. Investigations revealed that the patient had hypocalcemia, hyperphosphatemia and low parathyroid hormone levels. Since adequate treatment of hypoparathyroidism may lead to marked clinical improvement, this entity should be considered as a differential diagnosis in patients presenting with seizures and extensive intracranial calcifications.

B.P Venkatesh

Papers

Role of 3D Ultrasound and Doppler in Differentiating Clinically Suspected Cases of Leiomyoma and Adenomyosis of Uterus.

Multiple intracranial lipoma

Incidence and distribution of normal intracranial calcifications in adults on computed tomography.

Extensive intracranial calcifications on computerized tomography in a young adult with idiopathic hypoparathyroidism