Imaging in Intersex Disorders

Biswas, Krishna; Kapoor, Anu; Karak, Asis Kumar; Kriplani, Alka; Gupta, Devendra K.; Kucheria, Kiran; Ammini, Ariachery C.

doi:10.1515/jpem.2004.17.6.841

Cited by 25 publications

(11 citation statements)

References 16 publications

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“…MR has a sensitivity of 86%, specificity of 79%, and an accuracy of 85% for the detection of nonpalpable testes [Kanemoto et al, 2005] and has a great sensitivity for the detection of uterus (93%) and vagina (95%) in DSD cases [Secaf et al, 1994]. MR and US are considered equally sensitive in the evaluation of intrapelvic structures, but MR is better suited for gonads, although it is still not completely reliable for excluding intraabdominal gonads [Biswas et al, 2004;Mansour et al, 2012]. Ectopic gonads, testes, and noncystic immature ovaries have an intermediate signal intensity in T1-weighted MR images and a high signal intensity with an intermediate-signal-intensity outer rim on T2-weighted images [Gambino et al, 1992].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging Techniques in the Diagnostic Journey of Disorders of Sex Development

Guerra‐Júnior

Andrade

Barcelos

et al. 2017

Sex Dev

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Various disorders of sex development (DSD) result in an abnormal development of genitalia that may be recognized at prenatal ultrasonography, immediately after birth, or later in life. Because of the complex nature of DSD, the participation of a multidisciplinary team, including imaging or radiology technologists, is required to address the patient's medical needs. The first steps in the management of DSD are sex evaluation, which is based on factors such as the genotype, the presence, location, and appearance of reproductive organs, the potential for fertility, and the cultural background and beliefs of the patient's family. It is also important to ensure the detection of comorbidity (as in syndromes) and to define the etiology of DSD in order to offer the best prognosis. Ultrasonography is the primary modality for demonstrating internal organs, genitography is used to assess the urethra, vagina, and any fistulas, and magnetic resonance imaging is used as an additional modality to assess internal gonads and genitalia. This review presents the advantages and disadvantages and the sensitivity and specificity for each type of radiological imaging to help in the evaluation of DSD cases before and after birth.

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Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging Techniques in the Diagnostic Journey of Disorders of Sex Development

Guerra‐Júnior

Andrade

Barcelos

et al. 2017

Sex Dev

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“…Os procedimentos mais utilizados são ultra-sonografia em associação com genitografia (ou uretrocistografia miccional retró-grada) e, menos freqüentemente, tomografia computadorizada ou ressonância nuclear magnética da região pélvica 22,23 . A laparoscopia vem sendo realizada com maior freqüência e traz maior precisão a essa avaliação; a ela deve se associar, sempre que possível, cistoscopia intra-operatória, que fornece informações importantes a respeito da presença ou não de seio urogenital 24,25 .…”

Section: Definição De Ambigüidade Genital Quem Deve Ser Investigado?unclassified

The role of the pediatrician in the management of children with genital ambiguities

Guerra‐Júnior

Maciel‐Guerra

2007

J Pediatr (Rio J)

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“…1,2,5,6,15,19,20 The most often used studies are ultrasound in association with genitourinary imaging (or retrograde voiding cystourethrography) and, less frequently, computerized tomography or magnetic resonance imaging of the pelvic region. 22,23 Laparoscopy is being used with growing frequency and offers greater precision; whenever possible it should be used in association with intraoperative cystoscopy, which provides important information on the presence or absence of the urogenital sinus.…”

Section: S186mentioning

confidence: 99%

O pediatra frente a uma criança com ambigüidade genital

Guerra‐Júnior¹,

Maciel‐Guerra²

2007

J. Pediatr. (Rio J.)

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Objective:To present the diagnostic criteria of genital ambiguity, the initial medical management and the attitude expected of pediatricians. Sources:Review of the scientific literature in the form of articles indexed on MEDLINE, in English and Portuguese, published between 1990 and 2007 and dealing with the pediatric age group. Summary of the findings:Pediatricians have a fundamental role to play in the assessment of genital ambiguity, the purpose of which is to arrive at an etiologic diagnosis in the shortest possible time in order to define the patient's sex and plan treatment. There are specific diagnostic criteria, but, in general, genitalia are ambiguous whenever there is difficulty in attributing gender to a child. The pediatrician should inform the patient's family that assignment of their child's sex will depend upon detailed laboratory investigations, preferably carried out by a multidisciplinary team at a tertiary service. The 46,XX or 46,XY karyotypes are not alone sufficient to define the gender of rearing, although the test is fundamental to guide the investigation. When there are no palpable gonads, the first hypothesis should be congenital adrenal hyperplasia. Other causes included partial androgen insensitivity, 5α-reductase deficiency, partial gonadal dysgenesis and hermaphroditism. The family should be provided with support and information throughout the assessment process, and their participation is fundamental in the decision of which gender to rear the child in.Conclusions: Although cases of genital ambiguity are relatively rare for pediatricians, they should be wellinformed on the subject and the correct management of these conditions, since they will often be responsible for the initial guidance that families receive and for maintaining contact between them and the multidisciplinary team.J Pediatr (Rio J). 2007;83(5 Suppl):S184-191: Ambiguity, determination, differentiation, genitalia, intersex.

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Imaging in Intersex Disorders

Abstract: US still remains the modality of choice for screening patients with intersex disorders. MRI is helpful in cases with equivocal US findings.

Cited by 25 publications

References 16 publications

Imaging Techniques in the Diagnostic Journey of Disorders of Sex Development

Imaging Techniques in the Diagnostic Journey of Disorders of Sex Development

The role of the pediatrician in the management of children with genital ambiguities

O pediatra frente a uma criança com ambigüidade genital

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