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At least 469 records · Page 26Linked to original sources

Comparison of ultrafast half-Fourier single-shot turbo spin-echo sequence with turbo spin-echo sequences for T2-weighted imaging of the female pelvis.

So that we might evaluate the ultrafast half-Fourier single-shot turbo spin-echo (HASTE) sequence in T2-weighted MRI of the female pelvis and compare it with the turbo spin-echo (TSE) sequence, we prospectively studied 60 consecutive females with suspected abnormalities of the pelvis. For all MR examinations, we used a 1.5-T superconductive magnet with a phased array coil. The HASTE sequence was applied with TR/effective TE/echo train = infinity/90/64 and a 128 x 256 matrix (acquisition time: .3 sec/slice), conventional TSE imaging with 3,400 to 5,000/132/15 and a 128 x 256 matrix (mean acquisition time: 2 min 4 sec), and high-resolution TSE imaging with 3,400 to 5,000/132/15 and a 300 x 512 matrix (6 min 4 sec). Although the lesion conspicuity for the HASTE sequence was less than that for the high-resolution TSE sequences, artifacts (including ghosting, bowel motion, susceptibility difference, and chemical shift) were negligible on HASTE images of all patients. The lesion conspicuity for the HASTE sequence was significantly better than for the conventional TSE sequence. In spite of the very short acquisition time, the subjective scoring of the overall image quality for the HASTE sequence was significantly higher than for the conventional TSE sequence (P < .01) and were slightly lower than for the high-resolution TSE sequence. Compared with high-resolution TSE, HASTE provided clearer visualization of large leiomyomas and ovarian tumors but slightly poorer visualization of uterine cancer. In occlusion, HASTE sequence generates higher contrast and is free from motion and chemical shift artifact with much higher time efficacy. Because of limited image resolution, the HASTE sequence should be used when the high-resolution TSE imaging is suboptimal.

Adult↗

Anterior and posterior internal fixation of vertical shear fractures of the pelvis.

A laboratory study was undertaken to evaluate the effectiveness of alternative methods of fixation of unilateral vertical shear fractures of the pelvis. Prior to experimental testing, a biomechanical analysis was performed to estimate the forces that displace the hemipelvis in the presence of two different patterns of injury: an interforaminal sacral fracture and a disruption of the sacroiliac joint. These lesions were then experimentally created in five unembalmed human pelvises and sequentially fixed with an external Hoffmann frame alone, a Hoffmann frame with sacral bars, or sacral bars with either one or two bone plates placed across the symphysis pubis. Each pelvis/fixator system was mechanically tested by loading along the direction of the resultant muscle force predicted by the biomechanical analysis. During loading the proximal migration of the ilium was continuously recorded with a transducer. At intervals during loading, the three-dimensional displacement of the detached hemipelvis at the pubic symphysis was also measured using a stereophotographic technique. With both the sacral fracture and the sacroiliac disruption, the addition of posterior sacral rods substantially increased the strength and rigidity of fixation provided by the Hoffmann fixation frame alone (p less than 0.01). In specimens with a sacral fracture, the use of anterior plates with posterior rods restored 65-71% of the strength of the intact pelvis, in comparison with 46% observed with the combination of sacral rods with an anterior Hoffmann frame (p less than 0.01). All of the methods of fixation evaluated in this study were less successful in stabilizing the sacroiliac disruption.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗

Papillary adenocarcinoma of the renal pelvis in a child: case report and brief review of the literature.

Tumors of the renal pelvis are not common in adults and are extremely rare in children. Forty-eight cases of adenocarcinoma of the renal pelvis have been reported, with only one patient under 32 years of age. We report the youngest patient (an 11 year old boy) diagnosed with this tumor and discuss our approach to therapy. We also review the literature with respect to the characteristics and histogenesis of this rare neoplasm.

Adenocarcinoma, Papillary↗

Cost-effectiveness of colour duplex sonography compared with angiography of the pelvis and lower limb.

The present investigation was performed to assess the clinical consequences, utility and efficacy of colour duplex sonography (CDS) compared with angiography as a preoperative examination in aorta, pelvis and lower limb, and thus to estimate the cost-effectiveness of CDS. CDS was additionally performed in 53 consecutive patients referred for preoperative angiography of the lower limb. The results for 49 patients were reviewed and compared to assess the technique's clinical utility. The costs of the two methods and the consequences of inappropriate treatment were assessed. In 15 patients inadequate diagnoses were obtained at CDS. If surgery had been performed solely on the basis of the ultrasonographic diagnosis, repeat surgery would have been necessary in 9 patients. In a further 3 patients necessary surgery would not have been performed. Two patients would have been overtreated (unnecessary surgery instead of percutaneous transluminal balloon angioplasty). To correct the initial incorrect diagnosis the estimated yearly cost would be approximately 1.3 million Swedish crowns. In addition, complications and discomfort could be anticipated for the patients. Because of its low sensitivity CDS ist not cost-effective as a preoperative investigation of arteries of the pelvis and lower limb.

Adult↗

Bidirectional spread of disease via the subperitoneal space: the lower abdomen and left pelvis.

In early fetal life a persistent interconnection between the peritoneum and retroperitoneum of the abdomen and pelvis is formed--the subperitoneal space (SS). This paper serves to complete the description of the specific anatomical nuances of the SS as they relate to the bidirectional direct spread of disease in the left lower abdomen and pelvis. Described are the two avenues of communication (central and lateral pathways) within this portion of the SS. Selected cases illustrating the bidirectional spread of disease processes within this portion of the SS are reported.

Abdominal Neoplasms↗

Main renal vein invasion by a transitional cell carcinoma of the renal pelvis: documentation with CT.

Invasion of the main renal vein by transitional cell cancer of the renal pelvis is an infrequently reported event. No accurate clinical frequency of this phenomenon is available. Extensive invasion of the renal parenchyma by the tumor usually is present by the time it presents in the renal vein. This article represents but the second documenting main renal vein involvement depicted with computerized tomography in a patient with carcinoma of the renal pelvis.

Carcinoma, Transitional Cell↗

Effects of nerve stimulation on the spontaneous action potentials recorded in the proximal renal pelvis of the guinea-pig.

The effects of nerve stimulation on the electrical and mechanical activity of the smooth muscle of the proximal renal pelvis of the guinea-pig were investigated using standard tension and microelectrode recording techniques. Spontaneous action potentials were deemed to have been recorded from three cell types: (1) "pacemaker" cells (9 of > 120) had membrane potentials (MPs) of -42.1 +/- 2.9 mV and fired action potentials of a simple waveform; (2) "driven" cells (> 100) had more stable MPs of -56.1 +/- 1.2 mV (n = 36) and more complex "ureter-like" action potentials; (3) the remaining cells had MPs of -45.5 +/- 1.7 mV (n = 15) and action potentials with a waveform "intermediate" to groups (1) and (2). Nifedipine (0.1-1 microM) and Cd2+ (0.1-1 mM) blocked all spontaneous action potential discharge and depolarized the membrane to near -40 mV. Intramural nerve stimulation (10-50 Hz for 1-10 s) increased both the amplitude and frequency of the spontaneous contractile activity, this increase peaked in about 30 s and decayed slowly over several minutes. Nerve stimulation depolarized pacemaker and driven cells 9.1 +/- 3.5 (n = 3) and 1.6 +/- 0.7 (n = 6) mV, respectively; the frequency of their action potential discharge increased from 7.6 +/- 2.7 and 9.9 +/- 1.1/min to 17.3 +/- 0.5 and 11.1 +/- 1.4/min, respectively. The duration of the action potentials in driven cells also increased significantly for several minutes. All these effects were blocked by tetrodotoxin (TTX) (1.6 microM). It was concluded that the positive chronotropic and inotropic effects of nerve stimulation on renal pelvis contractility can be correlated with the changes in the frequency and duration of the action potentials recorded in driven cells.

Action Potentials↗

Caerulein and morphine in a model of visceral pain. Effects on the hypotensive response to renal pelvis distension in the rat.

In pentobarbital-anaesthetized rats (60 mg/kg, i.p.) renal pelvis distension with a pressure of 80 cm H2O caused a decline in mean arterial blood pressure. This pressure response, which disappeared rapidly after cessation of the distension, was used to study the effects of analgesic drugs known to be effective in renal colic pain in man. Morphine (0.75 and 1 mg/kg, s.c.) and the decapeptide caerulein (1.6, 4 and 8 microgram/kg, s.c.) abolished the pressure response. The effects of the largest doses lasted for at least 30 min. Ineffective in this respect were (a) desulphated caerulein (40 microgram/kg, s.c.) and (b) additional doses of pentobarbital (20 and 40 mg/kg, s.c.). This shows (a) the importance of the sulphated tyrosine (known from previous studies on central effects) and (b) the missing influence of the depth of anaesthesia. Naloxone (0.5 mg/kg, s.c.) abolished the effect of morphine (1 mg/kg, s.c.) but failed to influence that of caerulein (8 microgram/kg, s.c.). Even a fourfold dose of naloxone (2 mg/kg, s.c.) did not weaken the effect of caerulein. Naloxone, per se, was ineffective. These results suggest different mechanisms of the present effects of morphine and caerulein. It appears that renal pelvis distension in the anaesthetized rat can serve as a model of renal colic.

Animals↗

Experimental study of the pressure-volume and pressure-time relations in the completely obstructed pelvis of the porcine kidney. Part 1: Introduction and theory.

Little is known about pressure-volume and pressure-time relations of the obstructed renal pelvis. In a series of experiments with pigs the completely obstructed renal pelvis was infused with Ringer's lactate at a constant rate of 2 ml/min. On the basis of these experiments a mathematical description is given of the pressure-volume and pressure-time relations that were recorded.

Animals↗

Ten section approach to computed tomography of the pelvis.

This report describes a simplified anatomic approach to computerized tomography of the pelvis. This approach is based on the recognition of certain key features or landmarks in ten characteristic sections. These sections can be obtained routinely by using the L5 vertebral body as an initial reference point and then scanning sequentially at two centimeter intervals. These ten sections offer a relatively complete overview of the pelvis in most patients, and can serve, therefore, as a protocol for rapid screening.

Humans↗

A tonic component in the motility of the upper urinary tract (renal pelvis-ureter).

In isolated muscle strips of porcine renal pelvis and ureter, the calcium antagonist nifedipine (3.10(-7) moles/l) completely suppressed spontaneous phasic mechanical activity and the phasic components of an adrenaline-induced activation (P-component). In the presence of nifedipine, adrenaline induced in pelvis preparations (but not in the ureter) a tonic contraction (T-component) which was on average 61% of the control reaction (SD +/- 26%; n = 35).

Animals↗

Malignant tumours of the renal pelvis.

A review of the clinical data of 22 patients with malignant tumours of the renal pelvis, accounting for 10% of the total patient material of renal tumours, is presented. The earliest manifestation was prevalently haematuria, less often pain. In two thirds of the cases the diagnosis was established on radiological evidence and in one third the process remained undetected until surgical exposure of the kidney. The diagnostic difficulties involved by tumours of the renal pelvis and the value of the diagnostic methods are discussed. Nephroureterectomy with excision of a cuff of bladder was carried out in 15, nephrectomy in 5 cases. Three of the 22 patients have survived five years. Early diagnosis followed by total nephroureterectomy without delay may bring some improvement in the poor prognosis of these tumours.

Adult↗

Retrocaval ureter with carcinoma of the renal pelvis: report of a case.

A case of retrocaval ureter associated with carcinoma of the renal pelvis has been presented. This is the 2nd such case out of 110 cases reported in Japan. It is suggested that long term stagnation of urine is the cause for such a high incidence of malignant neoplasm involving the renal pelvis.

Adult↗

Magnetic resonance imaging of the female pelvis.

Magnetic resonance (MR) imaging is particularly well suited for the evaluation of the female pelvis because of the lack of respiratory motion and the multiplanar imaging ability of MR. The MR appearance of normal anatomy is dependent on the pulse sequence used. This is also true for pelvic pathology. Primary cervical carcinoma is best seen on T2-weighted images; parametrial extension and lymph node metastases are best evaluated on T1-weighted images. Endometrial carcinoma is also best seen on T2-weighted images. Absence of the junctional low intensity band of the uterus may indicate myometrial invasion by endometrial tumor, although more data are needed to make a final diagnosis. Uterine leiomyomata have a variable MR appearance which may be related to the degree of cellularity of the tumor. Our experience in the MR appearance of adnexal masses is limited. MR imaging should assume a more important role in imaging the female pelvis in the future.

Cervix Uteri↗

Right renal pelvis visualization in females: incidental detection in routine bone scanning.

A 22% incidence of renal pelvis or calyceal "hot spot" anomalies was found incidental to routine bone scanning. The majority of these anomalies were due to bilateral or right renal pelvis visualization, and statistical analysis determined there to be a significant female incidence, and persistence in repeat studies. This suggests an anatomical or functional basis for this finding.

Bone and Bones↗

Imaging the pediatric pelvis: the normal and abnormal genital tract and simulators of its diseases.

Imaging of the pediatric pelvis has proven of great use in defining the normal and abnormal genital tracts. Sonography is the key screening tool and often the only tool necessary for the diagnosis of problems related to ambiguous genitalia, ovarian and uterine masses, amenorrhea, and abdominal and pelvic pain. Computed tomography (CT) and magnetic resonance imaging (MRI) have key roles in the global assessment of the pelvis particularly with regard to the assessment of tumor spread.

Adolescent↗

The use of computed tomography in the diagnosis of carcinoma of the renal pelvis causing ureteropelvic junction obstruction.

The computed tomographic (CT) appearance of 5 cases of primary malignancy of the renal pelvis causing ureteropelvic junction (UPJ) obstruction is presented. The tumors appeared as enhancing thickened, nodular, and crescentic masses at the UPJ. Comparison is made to the thin, regular wall of the hydronephrotic pelvis caused by congenital UPJ obstruction. Differentiation from other causes of UPJ obstruction by CT is discussed. A CT scan is particularly valuable when the cause of UPJ obstruction remains elusive after urography and pyelography.

Adult↗