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Articolul precedent |
Articolul urmator |
948 40 |
Ultima descărcare din IBN: 2024-03-22 12:12 |
Căutarea după subiecte similare conform CZU |
618.15-07-089 (2) |
Mедицинские науки (11142) |
SM ISO690:2012 CUŢITARI, Irina, MIŞINA, Ana, ROTARU, Natalia. Abordarea radiologică în diagnosticul septului vaginal transversal complet. In: Buletin de Perinatologie, 2018, nr. 2(78-S), pp. 70-76. ISSN 1810-5289. |
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Buletin de Perinatologie | ||||||
Numărul 2(78-S) / 2018 / ISSN 1810-5289 | ||||||
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CZU: 618.15-07-089 | ||||||
Pag. 70-76 | ||||||
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Introduction. Total transverse vaginal septum (TTVS) is a much rare type of obstructive condition (1/2100-1/72000), which may be located at any level of the vagina. Adolescents with complete transverse vaginal septa generally present with primary amenorrhea and cyclic pelvic pain that increases over time. Objective of the study. The aim of this study was to establish the role of magnetic resonance imaging(MRI) and ultrasound(US) in patients with TTVS and rational evaluation and radiological approach in diagnosis and preoperative evaluation of the complete transverse vaginal septum. Material and methods. The retrospective and prospective study included 9 patients with TTVS operated in the department of surgical gynecology in the Institute of Mother and Child. The diagnosis was confi rmed by the US and MRI examinations. The mean age - 16.8±0.7 years old (95% CI:15.25-18.30). Each malformation of the vagina was classifi ed in accordance with The European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE) - ESHRE/ESGE (2013). For characterization of TTVS, the Williams CE. et al. (2014) classifi cation was used, which provides three anatomical features: (1) location (distance from vaginal entry to distal septum <3 cm (low), 3-6 cm (middle), and >6 cm (high); (2) septum thickness <1 cm (thin) and > 1 cm (thick), (3) perforated and imperforated. Results. After distribution, the isolated haematocolpos was diagnosed at 2/9 (22.2%), and haematocolpos associated with haematometra was detected at 7/9 (77.8%), the difference is statistically signifi cant (p>0.05). The max. hematocolpos - 128.7±10.7 mm (95% CI:104.1–153.3), the min. - 81.1±4.8 mm (95% CI:69.93–92.07). Volume 636.4±141.1 cm3 (95% CI:311.2-961.6). The low vaginal septum is more common (p = 0.0034) then the middle septum and constitued 8/9 (88.9%) vs. 1/9 (11.1%). The mean distance from vagina to full transverse septum was 21.6 ± 3.9 mm (95% CI: 12.58-30.53), including for low vaginal septum- 18.4 ± 2.5 mm (95% CI: 12.36 -24.38). Thin transverse vaginal septum met statistical truth more often than thick ones, < 1cm - 7(77.8%) vs > 1cm - 2(22.2%), the differences in the reliability of the limit = 0.0567). In most cases the complete transverse vaginal septum was an isolated Műllerian abnormality (after the ESHRE/ESGE -U0C0V3) and only in one case associated with the didelfi c uterus (U3bC2V3). One patient presents ectopic pelvic right kidney. Conclusions. Pelvic and/or transperineal ultrasound (US) is the initial exam of choice to assess the uterus, cervix and adnexa. Pelvic magnetic resonance imaging (MRI) is the current gold standart imaging modality. MRI is used to confi rm the presence of a transverse vaginal septum, evaluate its thickness, and determine its location, allows detailed depiction of all components of the anatomical abnormality, allowing for proper management and surgical planning. |
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Cuvinte-cheie total transverse vaginal septum, primary amenorrhea, hematocolpos, ultrasound, magnetic resonance imaging |
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