Hemato/hydrocolpos due to congenital urogenital anomalies are rare conditions discovered in neonatal, infant, and adolescent girls. Diagnosis is often missed or delayed owing to its rare incidence and nonspecific symptoms. If early correct diagnosis and treatment cannot be performed, late complications such as tubal adhesion, pelvic endometriosis, and infertility may develop. Congenital urogenital anomalies causing hemato/hydrocolpos are mainly of four types: imperforate hymen, distal vaginal agenesis, transverse vaginal septum, and obstructed hemivagina and ipsilateral renal anomaly, and clinicians should have adequate knowledge about these anomalies. This article aimed to review the diagnosis and treatment of these urogenital anomalies by describing embryology, clinical presentation, imaging findings, surgical management, and postoperative outcomes.

Continuous thin-slice coronal MR images using 3D FS-nSSFP and 3D T1-GRE sequences are sufficient to evaluate lumbar nerve root compression, and 3D FS-nSSFP is superior to 3D T1-GRE for depiction of lumbar nerve roots.

This article reviews the clinical utility of 3D magnetic resonance imaging (MRI) sequences optimized for the evaluation of various intraspinal lesions. First, intraspinal tumors with hypervascular components and arteriovenous malformations (AVM) are clearly shown on contrast-enhanced (CE)-3D T1-weighted gradient-echo (GE) sequences with high spatial resolution. Second, dynamic CE-3D time-resolved magnetic resonance angiography (MRA) shows delineated feeding arteries of intraspinal AVM or arteriovenous fistula (AVF), greatly aiding subsequent digital subtraction angiography (DSA). Third, 3D multiecho T2*-weighted GE sequences are used to visualize intraspinal structures and spinal cord lesions and are sensitive to the magnetic susceptibility of intraspinal hemorrhages. Three-dimensional balanced steady-state free precession (SSFP) and multishot 3D balanced non-SSFP sequences produce contiguous thin images with high signal-to-noise ratio (SNR) in short scanning times. Intraspinal cystic lesions and small nerve-root tumors in subarachnoid space can be viewed using 3D balanced SSFP. Spinal cord myelomalacia and cord compression can be evaluated on fat-suppressed multishot 3D balanced non-SSFP. Finally, a 3D T2-weighted fast spin-echo (FSE) sequence with variable flip angle (FA) refocusing pulse improves through-plane spatial resolution over conventional 2D T2-weighted FSE sequences while matching image contrast.

ABSTRACT. The occurrence of neurological symptoms after spinal anaesthesia has been reported with several local anaesthetics including lidocaine, prilocaine, mepivacaine, tetracaine and bupivacaine. Although hyperbaric bupivacaine is known to induce neurological symptoms less frequently than lidocaine, a few cases of cauda equina syndrome (CES) following the intraspinal injection of bupivacaine have been reported in the English literature. We describe lumbar MRI findings for a 29-year-old woman presenting with CES after caesarean section. Cauda equina syndrome (CES), a rare complication of spinal or epidural anaesthesia, results from injury to sacral roots in the neural canal. Because the nerves in the cauda equina lack a protective sheath as they pass through the distal end of the dural sac, they are particularly prone to injury from high concentrations of local anaesthetics. Although laboratory findings have suggested that lidocaine, mepivacaine and ropivacaine may have greater potential for neurotoxicity than bupivacaine [1], several cases of CES have been reported in association with the intrathecal injection of bupivacaine [2]. To the best of our knowledge, no spinal MRI findings have been presented for nerve root injury caused by spinal anaesthesia. Case reportA 29-year-old multiparous woman was admitted to the hospital in the 38th week of pregnancy for her second caesarean delivery. Her past medical history was unremarkable. On the second day of hospitalization, she went to the operating room. Combined spinalepidural anaesthesia (CSEA) was performed in the left decubitus position with 2.2 ml 0.5% hyperbaric bupivacaine administered intrathecally at the L3-4 interspace, followed by placement of a multiorifice epidural catheter at the T8-9 interspace. An 18-gauge epidural catheter was positioned 5 cm into the epidural space oriented in the cephalad direction to optimise cephalic spread of the anaesthetic. Surgery was allowed to proceed after sensory block from T5 to S5 was achieved. A total dose of 5.1 ml of 0.2% ropivacaine was administered using a patient-controlled epidural analgesia device over 75 min. Oxygen 3 l min -1 was given through a face mask; 20 min elapsed between induction of anaesthesia and uterine incision. The surgical procedure was completed without incident and the estimated blood loss was 800 ml.The patient did not fully recover from the motor and sensory blockade induced by CSEA, and at about 48 h post-partum was unable to walk because of lower extremity weakness. Neurological assessment confirmed sensory deficit to pinprick and vibration in the T3 to L5 distribution bilaterally with preservation of position sense. On the following day, she still exhibited hypaesthesia bilaterally in the T6 to L2 distribution with lower extremity weakness, which had shown minor improvement. Results of lumbosacral MRI without contrast medium were within normal limits, ruling out the possibility of spinal epidural haematoma or spinal infarction. Because the levels of sensory and motor dysfunction were nea...

BACKGROUND AND PURPOSE: Volumetry may be useful for evaluating treatment response and prognosis of intraocular lesions. Phantom, volunteer, and patient studies were performed to determine whether ocular MR volumetry is reproducible.