No abstract

No abstract

PurposeThe purpose of this study was to investigate magnetic resonance imaging (MRI) and 3-dimensional transperineal ultrasound (3D-TPUS) features of pelvic floor dysfunction (PFD) in symptomatic women in correlation with digital palpation and to define cut-offs for hiatal dimensions predictive of muscle dysfunction.MethodsThis prospective study included 73 women with symptoms suggesting PFD. 3D-TPUS, MRI, and digital palpation of the levator ani muscle were performed in all patients. Levator hiatal antero-posterior (LHap) diameter and area (LH area) were measured at rest and at maximum muscle contraction.ResultsThe reduction in LHap diameter and LH area during contraction was significantly less in women with underactive pelvic floor muscle contraction (UpfmC) than in those who had normal pelvic floor muscle contraction by digital palpation (P<0.001). Statistically significant positive correlations (P<0.001) were found between the Modified Oxford Score and 3D-TPUS and MRI regarding the reduction in the LHap diameter (r=0.80 and r=0.82, respectively) and LH area (r=0.60 and r=0.70, respectively). A reduction in LHap of <6.5% on 3D-TPUS and <7.6% on MRI predicted UpfmC with sensitivities of 46.2% and 82.7%, respectively. A reduction in LH area of <3.4% on 3D-TPUS and <3.8% on MRI predicted UpfmC with sensitivities of 75.0% and 88.5%, respectively. MRI was more sensitive in detecting levator avulsion (63.4%) than 3D-TPUS (27.1%).ConclusionMRI and 3D-TPUS had strong positive correlations with findings on palpation, and at certain cut-offs for hiatal dimensions, they can be used as complementary and objective tools to improve the accuracy of diagnosis and management planning of PFD.

No abstract

Objective: The aim of this work is to compare between intraoperative frozen section and scrape smear cytology in the diagnosis of ovarian neoplasm. Method: This study was performed between March 2011 and March 2012, on 50 patients presented with ovarian mass. Gross examination of the tumor removed was done by inspection and palpation. The specimen was then cut with a sharp knife into two halves. The area was scraped with a sharp scalpel or the end of a glass slide, depending upon the type of tissue. A semifluid drop thus obtained was spread over a glass slide. One to four slides per case were taken from different representative areas. The slides were labelled and immediately put into 95% ethyl alcohol and stained with hematoxylin-eosin. The specimens were then fixed in formalin. Paraffin blocks of the sections were processed in the routine way and sections were stained with hematoxylin and eosin (H and E). Assessment of the overall accuracy of the intraoperative diagnosis was classified as concordant or discordant. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of benign ovarian masses were 100%, 95.2%, 96.7%, 100% and 98% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of border line ovarian masses were 100%, 93.4%, 25%, 100% and 94% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of scraping technique in the diagnosis of malignant ovarian masses were 80%, 100%, 100%, 88.2% and 92% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of benign ovarian masses were 100%, 100%, 100%, 100% and 100% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of borderline * Corresponding author. A. M. Abdelghany et al. 29ovarian masses were 100%, 95.9%, 33.3%, 100% and 96% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of frozen section in the diagnosis of malignant ovarian masses were 90%, 100%, 100%, 93.8% and 96% respectively. Conclusion: Frozen section is more accurate than smear preparations in the intraoperative assessment of ovarian tumors in this study. However, the cytology preparations were helpful in supporting the histological diagnoses, and in some cases, provided additional useful information. Thus, cytology has a complementary role to frozen section in the intraoperative assessment of ovarian lesions. At the centers where the facilities of frozen section are not available, intraoperative scrape cytology is a useful tool for intraoperative diagnosis of tumor.