Biomedical subjects

J S Laméris

Publications and source records attributed to J S Laméris.

At least 19 recordsLinked to original sources

PubMed2006

[Increasing role for angiographic embolisation in the treatment of gastrointestinal haemorrhage].

Endoscopy is the primary diagnostic and therapeutic modality for the vast majority of patients with haemorrhage of the upper or lower digestive tract. In many hospitals, surgery is the therapy of choice when endoscopy fails or is impossible. In patients who have considerable co-morbidity and who are actively bleeding from the digestive tract, surgery is associated with a relatively high morbidity and mortality. Angiographic embolisation for haemorrhage from the upper or lower digestive tract is effective, with success rates varying from 50 to 90%. The risk of ischaemic complications of the procedure is acceptably low (< 5%). Angiography is not very time-consuming and does not preclude subsequent surgical treatment ifangiographic embolisation does not succeed. However, performing embolisation requires skill and experience and the procedure is not available everywhere. Angiographic embolisation is a valuable alternative to surgery and should be considered in all patients with haemorrhage of the digestive tract who cannot be treated by means of endoscopy.

Angiography↗

PubMed2005

A comparative study to validate the use of ultrasonography and computed tomography in patients with post-operative intra-abdominal sepsis.

PURPOSE: To validate abdominal ultrasonography and helical computed tomography in detecting causes for sepsis in patients after abdominal surgery and to determine improved criteria for its use. MATERIALS AND METHODS: Eighty-five consecutive surgical patients primarily operated for non-infectious disease were included in this prospective study. Forty-one patients were admitted to the intensive care unit. All patients were suspected of an intra-abdominal sepsis after abdominal surgery. Both ultrasonography (US) and helical abdominal computed tomography (CT) were performed to investigate the origin of an intra-abdominal sepsis. The images of both US and CT were interpreted on a four-point scale by different radiologists or residents in radiology, the investigators were blinded of each other's test. Interpretations of US and CT were compared with a reference standard which was defined by the result of diagnostic aspiration of suspected fluid collections, (re)laparotomy, clinical course or the opinion of an independent panel. Likelihood ratios and post-test probabilities were calculated and interobserver agreement was determined using kappa statistics. RESULTS: The overall prevalence of an abdominal infection was 0.49. The likelihood ratio (LR) of a positive test-result for US was 1.33 (95% CI: 0.8-2.5) and for CT scan 2.53 (95% CI: 1.4-5.0); corresponding post-test probabilities for US 0.57 (95% CI: 0.42-0.70) and for CT 0.71 (95% CI: 0.57-0.83). The LR of a negative test-result was, respectively, 0.60 (95% CI: 0.3-1.3) and 0.18 (95% CI: 0.06-0.5); corresponding post-test probabilities for US 0.37 (95% CI: 0.20-0.57) and for CT 0.15 (95% CI: 0.06-0.32) were calculated. CONCLUSION: Computed tomography can be used as the imaging modality of choice in patients suspected of intra-abdominal sepsis after abdominal surgery. Because of the low discriminatory power ultrasonography should not be performed as initial diagnostic test.

Abdomen↗

PubMed2004

[Bile duct injury after cholecystectomy: risk of mortality substantially higher].

Previous studies showed that bile duct injury after cholecystectomy is associated with substantial morbidity and a negative effect on Quality of Life. In a recent study, patients with a bile duct injury after cholecystectomy exhibited a 3-fold increase in mortality during a follow-up period of nine years compared to patients without injury. This is the first study to demonstrate a negative impact of bile duct injury on survival. Repair by a less experienced surgeon leads to an 11% higher mortality during follow-up. Cholangiography should probably be performed routinely during cholecystectomy. A bile duct lesion should be suspected when the patient has not recovered within 48 hours. Endoscopic or percutaneous treatment of stenoses or leakage is usually successful, even after several weeks.

Bile Ducts↗

PubMed2004

Diagnostic laparoscopy for primary and secondary liver malignancies: impact of improved imaging and changed criteria for resection.

BACKGROUND: Diagnostic laparoscopy (DL) combined with laparoscopic ultrasonography (LUS) has previously shown positive results as a staging modality for liver malignancies. Recent improvements in noninvasive diagnostic imaging techniques such as multiphasic spiral computed tomography, together with the policy that bilobar disease or the number of lesions is no longer considered an absolute exclusion criterion for curative resection, could reduce the additional value of DL. This study retrospectively analyzed the efficacy of DL combined with LUS for liver malignancies to assess the effect of improved imaging and changed criteria for resection. METHODS: All patients with primary or metachronous secondary liver malignancy eligible for resection in 1997 to 2002 were included. RESULTS: DL combined with LUS was performed in 84 consecutive patients (56 men and 28 women; mean age, 59 years) with primary (n = 33) or secondary (n = 51) liver malignancies. DL showed unresectability in 13 patients (39%) with primary malignancy. Exploratory laparotomy showed that an additional 5 (25%) of the remaining 20 patients had unresectable disease. DL showed unresectability in 5 patients (12%) with colorectal liver metastasis (n = 43). At laparotomy, another 7 (18%) of the remaining 38 patients had unresectable disease. In five patients (13%) from the latter group, LUS could not be performed because of adhesions from previous surgery. CONCLUSIONS: DL combined with LUS is an adequate staging modality for primary liver malignancies. For colorectal liver metastasis, more liberal resection criteria, a high failure rate due to adhesions from previous surgery, and better preoperative imaging probably resulted in a lower efficacy.

Aged↗

PubMed2002

Percutaneous evacuation (PEVAC) of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material: first results of a modified PAIR method.

BACKGROUND: Surgery is the treatment of choice in echinococcal cysts with cystobiliary fistulas. PAIR (puncture, aspiration, injection, and reaspiration of scolecidals) is contraindicated in these cases. AIM: To evaluate a modified PAIR method for percutaneous treatment of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material. PATIENTS: Twelve patients were treated: 10 patients with multivesicular cysts which contained non-drainable material and were complicated by spontaneous intrabiliary rupture, secondary cystobiliary fistulas, cyst infection, or obstructed portal or hepatic veins; and two patients with large univesicular cysts and a ruptured laminated membrane, one obstructing the portal and hepatic veins and one a suspected cystobiliary fistula. METHODS: The methods used, termed PEVAC (percutaneous evacuation of cyst content), involved the following steps: ultrasound guided cyst puncture and aspiration of cyst fluid to release intracystic pressure and thereby to avoid leakage; insertion of a large bore catheter; aspiration and evacuation of daughter cysts and endocyst by injection and reaspiration of isotonic saline; cystography; injection of scolecidals only if no cystobiliary fistula was present; external drainage of cystobiliary fistulas combined with endoprosthesis or sphincterotomy; catheter removal after complete cyst collapse and closure of the cystobiliary fistula. RESULTS: In all 12 patients initial cyst size was 13.1 (6-20) cm (mean (range)). At follow up 17.9 (4-30) months after PEVAC, seven cysts had disappeared and five cysts had decreased to 2.4 (1-4) cm (p=0.002). In eight patients with multivesicular cysts, a cystobiliary fistula, and infection, cyst size was 12.5 (6-20) cm, catheter time 72.3 (28-128) days, and hospital stay 38.1 (20-55) days. At 17.3 (4-28) months of follow up, six cysts had disappeared and in two cysts residual size was 1 and 2.9 cm, respectively (p=0.012). In four patients without a cystobiliary fistula, cyst size was 14.4 (12.7-16) cm, catheter time 8.8 (3-13) days, and hospital stay 11.5 (8-14) days. At 19.3 (9-30) months of follow up, one cyst had disappeared and three cysts were 85 (69-94)% smaller (2.2 (1-4) cm) (p=0.068). CONCLUSION: PEVAC is a safe and effective method for percutaneous treatment of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material.

Adult↗

PubMed2002

Prospective comparative study of spiral computer tomography and magnetic resonance imaging for detection of hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is often detected at a relatively late stage when tumour size prohibits curative surgery. Screening to detect HCC at an early stage is performed for patients at risk. AIM: The aim of this study was to compare prospectively the diagnostic accuracy and classification for management of the two state of the art secondline imaging techniques: triphasic spiral computer tomography (CT) and super paramagnetic iron oxide (SPIO) enhanced magnetic resonance imaging (MRI). PATIENTS: Sixty one patients were evaluated between January 1996 and January 1998. Patients underwent CT and MRI within a mean interval of 6.75 days. METHODS: CT and MRI were evaluated blindly for the presence and number of lesions, characterisation of these lesions, and classification for management. For comparison of the data on characterisation, the CT and MRI findings were compared with histopathological studies of the surgical specimens and/or follow up imaging. Data of patients not lost to follow up were available to January 2001. RESULTS: SPIO enhanced MRI detected more lesions and overall smaller lesions than triphasic spiral CT (number of lesions 189 v 124; median diameter 1.0 v 1.8 cm; Spearman rank's correlation coefficient 0.63, p<0.001). There was no significant difference in accuracy between CT and MRI for lesion characterisation. The agreement in classification for management was very good (weighted kappa 0.91, 95% CI 0.83-0.99). CONCLUSION: SPIO enhanced MRI detects more and smaller lesions, but both techniques are comparable in terms of classification for management. SPIO enhanced MRI may be preferred as there is no exposure to ionising radiation.

Adult↗

PubMed2000

[Virtual colonoscopy].

Virtual colonoscopy is a fundamentally new imaging technique, in which volumetric CT or MRI data are processed to virtual endoscopic images of the colon. The main application is early detection of colorectal cancer. To date, no data of studies on screening for colorectal cancer are available. The results of clinical studies show comparable results for endoscopy and virtual colonoscopy for the detection of clinically relevant polyps (> or = 1 cm) and better results of virtual colonoscopy than of conventional barium studies. Whether virtual colonoscopy as a minimally invasive technique will gain a place in screening for colorectal cancer depends on several issues such as costs, effectiveness and acceptance by patients.

Colonic Polyps↗

PubMed2000

MRI with mangafodipir trisodium in the detection and staging of pancreatic cancer.

The purpose of this study was to compare prospectively computed tomography (CT) and magnetic resonance (MR) imaging before and after mangafodipir trisodium infusion for the detection and staging of focal pancreatic lesions. From November 1996 to October 1997, 43 consecutive patients suspected to have a focal pancreatic lesion were included in a phase III study. Triphasic helical CT was performed, as well as MRI at 1.5 T, as follows: axial T1-weighted (T1w) turbo spin echo (TSE), spectral presaturation with inversion recovery (SPIR) T1w TSE, T1w turbo field echo (TFE), and SPIR T2w TSE before and after mangafodipir trisodium (0.01 mmol/ml, 0.5 ml/kg) infusion. Imaging results were correlated with surgery, laparoscopy, laparoscopic ultrasound, and biopsy. Objective measurements were performed by measuring signal intensities (SIs) of lesion and parenchyma and calculating contrast indexes (CIs) and contrast-to-noise-ratios (CNRs) to assess the delineation of the tumor. SIs were correlated with four phantom standards with a known SI. Thirty-eight pancreatic adenocarcinomas were present, as well as one cystadenoma, two papillomas, and two cases of focal pancreatitis. SI measurements revealed significant increases in CIs for the lesion compared with the parenchyma in T1w TSE (69.7 vs 152.7; P = 0. 0003) and T1w TFE (107.8 vs 194.2; P = 0.0002). These series also revealed significant increases in CNRs (for T1w TSE: 9.7 vs 13.0; P = 0.0407 and for T1w TFE: 14.5 vs 26.1; P = 0.0001). In the other series, there was no significant increase. CT detected 38 lesions, MRI without mangafodipir trisodium detected 39 lesions, and MRI with mangafodipir trisodium detected 40 lesions, giving detection accuracy rates of 88%, 91%, and 93%, respectively. Staging accuracy rates for vascular ingrowth were 81%, 75%, and 81%, respectively. Overall staging accuracy rates were 57%, 54%, and 54%, respectively, mostly due to undetected small metastases in the peritoneum, omentum, or liver (< 1 cm). This study indicates that a) MRI after mangafodipir trisodium gives a better delineation of the tumor in T1w series, but b) does not significantly improve the detection rate and staging accuracy of focal pancreatic lesions over MRI without this contrast medium.

Adult↗

PubMed2000

Relationship between sphincter morphology on endoanal MRI and histopathological aspects of the external anal sphincter.

Atrophy of the external anal sphincter can be shown only on endoanal magnetic resonance imaging (MRI). Until now no study has compared the morphological endoanal MRI findings with histopathological aspects of the external anal sphincter. The aim of this study was to validate the MRI interpretation of the external anal sphincter using histology as a "gold standard." In this prospective study 25 consecutive unselected women (median age 48 years, range 27-72) with fecal incontinence due to obstetric trauma were assessed preoperatively with endoanal MRI. All patients underwent anterior sphincteroplasty within 6 months of the preoperative assessment. During sphincter repair, a biopsy specimen was taken both from the left and right lateral parts of the external anal sphincter. Interpretation of MRI was performed by one of the radiologists (J.S.), and biopsy specimens were evaluated by the pathologist (W.J.M.). Both were blinded to the interpretation of the other. MRI revealed external anal sphincter atrophy in 9 of the 25 patients (36%). Histopathological investigation confirmed these findings in all but one. In one additional patient atrophy was detected on histological investigation while the morphology of the external anal sphincter was classified as normal on MRI. In detecting sphincter atrophy endoanal MRI showed 89% sensitivity, 94% specificity, 89% positive predictive value, and 94% negative predictive value. MRI correctly identified sphincter morphology in 23 of 25 cases (92%). This study demonstrates that endoanal MRI accurately identifies normal and abnormal external anal sphincter morphology. Endoanal MRI is therefore a valuable preoperative diagnostic tool.

Adult↗

PubMed2000

Percutaneous treatment of bile duct stones in patients treated unsuccessfully with endoscopic retrograde procedures.

BACKGROUND: The preferred treatment for stones in the bile duct is endoscopic sphincterotomy followed by stone extraction. When this fails, percutaneous treatment is an alternative to surgery. The purpose of this study was to evaluate the success and complication rate of percutaneous treatment. METHODS: Between April 1990 and April 1997, a total of 31 consecutive patients (20 men, 11 women, mean age 70.1 years) underwent percutaneous treatment of bile duct stones (average of 2.2 per patient, range 1 to 10). The percutaneous treatment was considered successful if all stones could be removed. Time and number of sessions needed for imaging, percutaneous treatment, and complications were scored. RESULTS: Twenty-seven patients (87%) were free of stones after 2 to 15 sessions (mean 5.6). The median time for treatment was 16 days (3 to 299). Complications occurred in 3 of the 31 patients: one myocardial infarction during extracorporeal shockwave lithotripsy, one pancreatitis, and one bacteremia. None of these complications were life threatening. Four patients (13%) underwent surgery after failed percutaneous treatment. CONCLUSION: Percutaneous treatment of bile duct stones is an alternative with a high success rate when endoscopic stone removal fails. Surgery can be avoided in nearly 90% of cases.

Adult↗

PubMed2000

US and fluoroscopic-guided percutaneous jejunostomy: experience in 49 patients.

PURPOSE: To assess the feasibility and safety of a variety of techniques for percutaneous jejunostomy. MATERIALS AND METHODS: Percutaneous jejunostomy was attempted on 53 occasions in 49 patients under US and fluoroscopic guidance. During the study period, thicker needles, Cope anchors, and intravenous glucagon were introduced to improve access, dilate, and immobilize the jejunum. Technical success rates, complications, catheterization period, and reasons for catheter removal were prospectively studied. Prognostic factors for successful procedures and complications were determined. RESULTS: Forty-six (87%) procedures were technically successful. Previous gastrointestinal surgery (P = .01) and a combination of thicker needles, Cope anchors, and intravenous glucagon (P = .0001) were associated with a higher technical success rate. Complications (n = 6; pericatheter leakage in four of six) were observed more frequently in older patients (P = .01). The 30-day mortality rate was 17%, one death may have been procedure related. Forty-three catheters were removed (elective, n = 36; other, n = 7) after 1-597 days (median, 49). Three catheters remained in situ for 139-482 days (median, 410). CONCLUSIONS: Percutaneous jejunostomy is a feasible and relatively safe technique for long-term feeding. Leakage is the main problem, which warrants additional study.

Adult↗

PubMed2000

Imaging of anorectal disease.

BACKGROUND: Over the past two decades developments in imaging have changed the assessment of patients with anorectal disease. METHODS: The literature on imaging techniques for anorectal diseases was reviewed over the period 1980-1999. RESULTS: For the staging of primary rectal tumours, phased array magnetic resonance imaging (MRI) may be regarded as the most appropriate single technique. The combination of endosonography or endoluminal MRI with ultrasonography or spiral computed tomography yields similar results. All techniques have limitations both for local staging and in the assessment of distant metastases. MRI or positron emission tomography is preferable for tumour recurrence. For perianal fistula, high-resolution MRI (phased array or endoluminal) is the technique of choice. For constipation, defaecography is the preferred technique, nowadays with emphasis on functional information. The role of magnetic resonance defaecography is currently being evaluated. For faecal incontinence, endosonography and endoluminal MRI give similar results in detecting sphincter defects; endoluminal MRI has the advantage of detecting external sphincter atrophy. CONCLUSION: High-resolution MRI, endosonography and defaecography are currently the optimal imaging techniques for anorectal disease.

Anus Diseases↗

PubMed2000

Sonography for hip joint effusion in adults with hip pain.

OBJECTIVE: To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. METHODS: Patients (n = 224) aged 50 years or older with hip pain, referred by the general practitioner for radiological investigation, underwent a standardised examination. The distance between the ventral capsule and the femoral neck, an increase in which represents joint effusion, was measured sonographically. Joint effusion was defined in three different ways: "effusion" according to Koski's definition, "major effusion", and "asymmetrical effusion" based on only individual side differences. RESULTS: "Effusion" was present in 80 (38%), "major effusion" in 20 (9%), and "asymmetrical effusion" in 47 (22%) patients. Pain in the groin or medial thigh, pain aggravated by lying on the side, decreased extension/internal rotation/abduction/flexion, painful external rotation, and pain on palpation in the groin showed a significant relation (adjusted for age and radiological osteoarthritis of the hip) with ultrasonic hip joint effusion. "Major effusion" showed a significant relation with an increased ESR. When patients with bilateral pain and increased ESR were excluded, a side difference in the range of motion of extension of the hip was shown to be a good predictor for "asymmetrical effusion" (positive predictive value: 71%, negative predictive value: 80%). CONCLUSION: This study showed a relatively high prevalence of ultrasonic joint effusion in adults with hip pain in general practice. Furthermore the results indicate a relation between joint effusion and clinical signs.

Aged↗

PubMed2000

Normal anal sphincter anatomy and age- and sex-related variations at high-spatial-resolution endoanal MR imaging.

PURPOSE: To describe the various patterns of normal sphincter anatomy as seen at endoanal magnetic resonance (MR) imaging and to assess sex- and age-related variations in the dimensions of the anal sphincter to refine the diagnosis of sphincter disorders. MATERIALS AND METHODS: Endoanal MR imaging (1.5 T) was performed in 100 healthy volunteers (50 women, 50 men) evenly distributed between ages 20 and 85 years. The essential anatomic structures were evaluated, and various patterns in men and women were recorded. The thickness of the anal sphincter muscles and the length of the anal canal were measured, and age- and sex-related correlations were studied. RESULTS: Sex-related differences included a significantly shorter external sphincter in women than in men both laterally (mean, 27.1 mm +/- 5.4 vs 28.6 mm +/- 4.3; P: <.05) and anteriorly (mean, 14.0 mm +/- 3.0 vs 27.0 mm +/- 53.0; P: <.051). The superficial transverse perineal muscle is located more superiorly in women than in men. The central perineal tendon in men is a central muscular insertion point; in women, it represents an area where muscle fibers imbricate. Age-related variations included a significant decrease in the thickness of the external sphincter in men (P: <.01). Significant decrease in the thickness of the longitudinal muscle and increase in the thickness of the internal sphincter were noted in both sexes (P: <.01). CONCLUSION: High-spatial-resolution endoanal MR imaging provides excellent visualization of pelvic floor structures. Severe atrophy as it occurs in incontinent patients should be differentiated from physiologic, age-related thinning of the external sphincter and longitudinal muscle.

Adult↗

PubMed2000

CT criteria for venous invasion in patients with pancreatic head carcinoma.

The purpose of the study was to evaluate CT criteria for venous invasion in patients with potentially resectable carcinoma of the pancreatic head, with surgical and histopathological correlation. In 113 patients evaluated with spiral CT for suspected pancreatic head carcinoma, several CT criteria for venous invasion were scored prospectively for the portal vein (PV) and the superior mesenteric vein (SMV): length of tumour contact with PV/SMV (0 mm, < 5 mm, > 5 mm); circumferential involvement of the vein (0 degree, 0-90 degrees, 90-180 degrees, > 180 degrees); degree of stenosis; irregularity of the vessel margin; and tumour convexity towards vessel. 65 patients underwent surgery. Pancreatic head carcinoma was proven and pathology of the vascular margin was obtained in 50 of these patients. CT findings for single and combined criteria were correlated with pathology in these 50 patients, 30 of whom showed venous ingrowth. Invasion was found in all cases with SMV narrowing (n = 7), PV contour involvement > 90 degrees (n = 6), PV narrowing (n = 5) and PV wall irregularity (n = 3). The vascular ingrowth rate was 88% (15/17) for tumour concavity towards the PV or SMV. Poor predictors of ingrowth were length of tumour contact with PV > 5 mm (78% ingrowth, 14/18) and contour involvement of the SMV > 90 degrees (83% ingrowth, 10/12). Absence of vascular ingrowth could not be predicted in 100%. In conclusion, CT criteria can predict a high risk of invasion in potentially resectable tumours. Narrowing of the SMV and the PV seems the most reliable criterion, as well as circumferential involvement of the PV > 90 degrees. The best combination of criteria was tumour concavity with circumferential involvement > 90 degrees (sensitivity 60% and positive predictive value 90%).

Adult↗

PubMed1999

[Bile duct lesions in portal vein thrombosis].

Four patients, three men aged 51, 45 and 31 and a woman aged 22 years with portal vein thrombosis presented with symptoms or signs of biliary obstruction. Laboratory examination showed cholestasis. Cholangiography demonstrated smooth indentations of the common bile duct consistent with external compression by collateral veins. The clinical course varied from spontaneous resolution of both symptoms and serum biochemical abnormalities to persistent cholestasis. In two patients, surgical treatment (splenorenal shunt and hepaticojejunostomy) failed due to the presence of numerous collateral veins. Biliary strictures secondary to formation of a portal cavernoma, so-called portal biliopathy, is a rather unknown complication of portal vein thrombosis. Although the majority of patients is asymptomatic, porto-systemic shunt surgery or endoscopic biliary intervention may be indicated in symptomatic cases.

Adult↗

PubMed1999

Accuracy of MR phase mapping for temperature monitoring during interstitial laser coagulation (ILC) in the liver at rest and simulated respiration.

The chemical shift or proton-resonance frequency (phase mapping) can be used to measure temperature changes. As a subtraction technique, it requires scans at exactly the same location, making it prone to respiration-induced artifacts. The accuracy of magnetic resonance (MR) phase mapping for temperature monitoring of interstitial laser coagulation (ILC) was therefore investigated in two ex vivo models with simulated respiration. MR temperatures were calibrated to interstitially measured temperature. Gradual cooling of a homogenous medium (gel) was monitored for four starting temperatures (room temperature, 40 degrees C, 50 degrees C, and 60 degrees C) during 30 min. Temperature increases were measured during ILC in ex vivo porcine liver with Nd:YAG for 6 min with 5 Watt. Experiments were performed at rest and with simulated respiratory motion (both n = 5). In liver, accuracy did not decrease with respiration simulation (P = 0.32), whereas a significant decline was found in the gel model (P = 0.002). In all experiments a small drift over time was observed between temperature determined with MR and thermoprobes. Correction for temperature-independent phase-shift at a reference location did not enhance agreement. Temperatures could be determined correctly by MR in the moving liver within a range of +/-3.5 degrees C after 6 min of laser application (95% confidence interval), justifying further pre-clinical studies.

Analysis of Variance↗

PubMed1999

Measurement of sacroiliac joint stiffness in peripartum pelvic pain patients with Doppler imaging of vibrations (DIV).

OBJECTIVES: The research question of the present study was: are sacroiliac joint stiffness levels of peripartum pelvic pain patients different from those of healthy subjects? STUDY DESIGN: A cross-sectional comparative sacroiliac joint stiffness analysis of peripartum pelvic pain patients with healthy subjects. In previous studies we introduced a new technique, Doppler imaging of vibrations (DIV), to assess sacroiliac joint stiffness using colour Doppler imaging and vibrations. The measurements were performed on a group of peripartum pelvic pain patients (n=56) and on a control group (n=52). The differences in sacroiliac joint stiffness between the patient group and the control group were tested statistically by means of the Wilcoxon's two sample test, the chi-square test and Student's t-tests. RESULTS: Both patients and controls displayed stiff as well as unstiff joints with no significant difference. There was a significant difference between the groups with regard to the relative difference of sacroiliac joint stiffness between left and right. CONCLUSIONS: A diagnostic tool which can possibly be developed in the future could demonstrate an objective finding among women with peripartum pelvic pain. DIV is easy to apply and non-invasive. Asymmetric stiffness of the sacroiliac joints seems to be more directly related to low back pain and pelvic pain, not the stiffness level of a single sacroiliac joint.

Adult↗