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Angiography of the ovarian artery in adnexal lesions.

Selective catheterization of the ovarian artery was performed in 39 women with pelvic tumor. Previously the combination of ultrasound and bilateral selective internal iliac angiography was proven to be valuable in the evaluation of gynecologic lesions. The present series demonstrates that selective ovarian angiography still enhances the possibilities for a correct preoperative diagnosis.

Adult↗

Prevalence and distribution of adnexal findings suggesting endometriosis in patients with MR diagnosis of adenomyosis.

The purpose of this investigation was to establish the prevalence and distribution of MR findings associated with pelvic endometriosis in patients with a MRI diagnosis of adenomyosis. Retrospective review of the pelvic MRI in 59 patients (age 32-54 years, mean 42 years) who met strict MRI criteria for adenomyosis was performed. T1 weighted fat saturated and T2 weighted images in these patients were reviewed for the presence or absence of T1 bright signal suggesting endometriosis in any of nine locations (uterine serosa, right and left ovary, right and left fallopian tube, right and left broad ligament, and right and left pelvic side wall). 20 (20/59) patients (34%), showed characteristic MRI features associated with endometriosis. A total of 54 sites of involvement were identified (uterine serosa n = 17, ovaries n = 14, broad ligaments n = 10, fallopian tubes n = 8, pelvic side walls n = 5) in 20 patients with an average of 2.7 sites per patient. Implants (n = 43) were more common than endometriomas (n = 11). Endometriomas occurred most often in the ovaries (ovaries n = 9, broad ligament n = 2) whereas implants were seen on all locations (uterine serosa n = 17, ovaries n = 5, broad ligaments n = 8, fallopian tubes n = 8, pelvic side walls n = 5). One third of patients with adenomyosis diagnosed by MRI also had MRI findings of endometriosis, with serosal implants being the most common finding. Imaging protocols should routinely include T1 weighted fat saturated imaging sequences in order to detect coexistent endometriosis in patents undergoing pelvic MRI for the diagnosis of adenomyosis.

Abdominal Wall↗

Adnexal gland secretion markers in unexplained asthenozoospermia.

Prostatic acid phosphatase, prostate-specific antigen, and zinc as markers of prostate, and fructose as marker of seminal vesicles were investigated in the seminal plasma of 35 idiopathic asthenozoospermic and 20 normal subjects to evaluate their relationship with sperm motility. Total seminal plasma levels of the three prostatic markers and, to a lesser extent, total fructose levels were lower in asthenozoospermic patients, and in all the pooled subjects, the same levels were directly correlated with the motility of ejaculated spermatozoa. When the levels of the biochemical markers were expressed as concentrations in seminal plasma, only prostatic acid phosphatase levels remained lower in asthenozoospermic patients and they maintained a direct correlation with sperm motility in all the pooled subjects. The PAP/Zn/Fr (representing the ratio between PAP concentration and free Zn available for spermatozoan uptake) was lower in asthenozoospermic patients and it was also directly related to sperm motility in all the pooled subjects. These data suggest that altered sperm motility is associated with a probable impairment of sex accessory gland function in subjects with idiopathic asthenozoospermia, while prostatic acid phosphatase seems mainly related to sperm motility.

Acid Phosphatase↗

Reliability of adnexal mass mobility in distinguishing possible ectopic pregnancy from corpus luteum cysts.

OBJECTIVE: The purpose of this study was to evaluate the utility of paraovarian pelvic mass mobility as an indicator of mass identity, corpus luteum versus other, in ruling out ectopic pregnancy. METHODS: This was a retrospective study of all pelvic sonographic examinations on patients with first-trimester complications seen over an 18-month period at a large urban emergency department. All pregnant patients with signs or symptoms of concern for ectopic pregnancy were scanned to evaluate for intrauterine pregnancy. Masses suggestive of either a corpus luteum or an ectopic pregnancy were separated from the ovary with abdominal palpation and endovaginal transducer movement. The ultrasound director and assistant director reviewed videos of all scans. Results of mass separation and outcome were recorded. Independent movement of a mass and ovary was defined as movement of the mass away from the ovary, sliding past the ovary or rotation past the ovary. Statistical analysis included descriptive statistics, inter-rater reliability, the Fisher exact test, and sensitivity, specificity, and negative and positive predictive values. RESULTS: A total of 78 patient scans fit the criteria, and in 27 of them, the mass separated from the ovary. Twenty-three patients had ectopic pregnancy as the final diagnosis, and in 2 of these, no independent mass movement occurred. Lack of independent movement of the mass and ovary was significantly more common in patients without a final diagnosis of ectopic pregnancy (P < .0001). The negative predictive value was 96.1%. CONCLUSIONS: Lack of independent movement of an adjacent mass and ovary was strongly associated with absence of ectopic pregnancy.

Adnexa Uteri↗