The establishment of a 3D anatomical coordinate system for defining vaginal axis and spatial position

Sinex, Deanna C.E.; Bowen, Shaniel T.; Kashkoush, Ahmed; Rosemond, Arianna; Carter, Danielle; Menon, Prahlad G.; Moalli, Pamela; Abramowitch, Steven D.

doi:10.1016/j.cmpb.2021.106175

Cited by 4 publications

(2 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A PCS was established to account for differences in patient position in the MRI scanner 15 . The medio‐lateral ( x ) axis was defined by the line connecting the ischial spines, where its midpoint provided the origin of the PCS.…”

Section: Methodsmentioning

confidence: 99%

“…A PCS was established to account for differences in patient position in the MRI scanner. 15 The medio-lateral (x) axis was defined by the line connecting the ischial spines, where its midpoint provided the origin of the PCS. The anteriorposterior (y) axis was given by the line orthogonal to the x-axis starting from the origin to the point one-third along the inferior-superior length of the pubic symphysis.…”

Section: D Pelvic Coordinate System Definitionmentioning

confidence: 99%

See 1 more Smart Citation

Vaginal morphology and position associated with prolapse recurrence after vaginal surgery: A secondary analysis of the DEMAND study

Bowen

Moalli

Abramowitch

et al. 2023

BJOG

Self Cite

View full text Add to dashboard Cite

ObjectiveTo identify vaginal morphology and position factors associated with prolapse recurrence following vaginal surgery.DesignSecondary analysis of magnetic resonance images (MRI) of the Defining Mechanisms of Anterior Vaginal Wall Descent cross‐sectional study.SettingEight clinical sites in the US Pelvic Floor Disorders Network.Population or SampleWomen who underwent vaginal mesh hysteropexy (hysteropexy) with sacrospinous fixation or vaginal hysterectomy with uterosacral ligament suspension (hysterectomy) for uterovaginal prolapse between April 2013 and February 2015.MethodsThe MRI (rest, strain) obtained 30–42 months after surgery, or earlier for participants with recurrence who desired reoperation before 30 months, were analysed. MRI‐based prolapse recurrence was defined as prolapse beyond the hymen at strain on MRI. Vaginal segmentations (at rest) were used to create three‐dimensional models placed in a morphometry algorithm to quantify and compare vaginal morphology (angulation, dimensions) and position.Main outcome measuresVaginal angulation (upper, lower and upper–lower vaginal angles in the sagittal and coronal plane), dimensions (length, maximum transverse width, surface area, volume) and position (apex, mid‐vagina) at rest.ResultsOf the 82 women analysed, 12/41 (29%) in the hysteropexy group and 22/41 (54%) in the hysterectomy group had prolapse recurrence. After hysteropexy, women with recurrence had a more laterally deviated upper vagina (p = 0.02) at rest than women with successful surgery. After hysterectomy, women with recurrence had a more inferiorly (lower) positioned vaginal apex (p = 0.01) and mid‐vagina (p = 0.01) at rest than women with successful surgery.ConclusionsVaginal angulation and position were associated with prolapse recurrence and suggestive of vaginal support mechanisms related to surgical technique and potential unaddressed anatomical defects. Future prospective studies in women before and after prolapse surgery may distinguish these two factors.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: D Pelvic Coordinate System Definitionmentioning

confidence: 99%

Vaginal morphology and position associated with prolapse recurrence after vaginal surgery: A secondary analysis of the DEMAND study

Bowen

Moalli

Abramowitch

et al. 2023

BJOG

Self Cite

View full text Add to dashboard Cite

show abstract

A simplified method for evaluating the anatomical axis of the upper two-thirds of the vagina on MRI: A hospital-based cross-sectional study

OuYang,

Li,

Wang

et al. 2023

gocm

View full text Add to dashboard Cite

BackgroundsPelvic organ prolapse commonly affects the upper two-thirds of the vagina. However, evaluating this region in its normal position presents challenges. This study aimed to assess the anatomical axis of this vaginal segment using pelvic magnetic resonance imaging measurements.MethodsA retrospective study of 614 hospitalized women from two hospitals, who were rigorously screened to exclude those with Pelvic Organ Prolapse or known anatomical variations (median age: 43 years, range: 17–76 years). Two reference lines were used: the pubococcygeal line (PCL) and a line from the inferior pubic symphysis to the third sacral vertebra (PS3L). Distances between the distal, middle, and apical points of the upper vagina and the reference lines, as well as the angles between the upper vagina and the reference lines, were measured. Comparisons were made among different age groups.ResultsThe median distances from the distal, middle, and apical vaginal points to the PCL were 0.4 cm (interquartile range [IQR]: 0.0–0.7 cm), 2.1 cm (IQR: 1.7–2.5 cm) and 3.1 cm (IQR: 2.5–3.7 cm), respectively. The median PCL-vaginal angle was 29.0° (IQR: 23.0–34.0°). The median distances from the distal, middle, and apical vaginal points to the PS3L were -0.5 cm (IQR: -0.9–0.0 cm), 0.0 cm (IQR: -0.4–0.6 cm), and -0.2 cm (IQR: -0.9– 0.0 cm), respectively. The median PS3L-vaginal angle was 0.0° (IQR: -4.0–7.0°). Women aged 50 years or older had slightly lower vaginal points and slightly larger angles than younger groups in relation to both reference lines (p < .001). The vaginal axis in younger groups appeared parallel to the PS3L.ConclusionsThe axis of the upper two-thirds vagina was proximate to a line from the inferior pubic symphysis to the third sacral vertebra, particularly in younger women. It will likely become a simplified method for roughly assessing the vaginal axis in its situ at first glance.

show abstract

Computational modeling of basal ganglia hemorrhage morphology improves functional outcome prognostication after minimally invasive surgical evacuation

Kashkoush,

Achey,

Davison

et al. 2024

J NeuroIntervent Surg

View full text Add to dashboard Cite

IntroductionAnatomic factors that predict outcomes following basal ganglia intracranial hemorrhage (bgICH) evacuation are poorly understood. Given the compact neuroanatomic organization of the basal ganglia, we hypothesized that bgICH spatial representation could predict postoperative functional outcomes.MethodsPatients undergoing minimally invasive surgical bgICH evacuation between 2013 and 2024 at one center were retrospectively reviewed. bgICH volumes were segmented and stereotactically localized using anatomic landmarks. Heat maps that identified bgICH spatial representation across functional outcome states were generated. Differential bgICH volume overlap with each heat map was calculated after subtracting out that patient’s contribution to the map. Area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic accuracy of differential volume overlap for poor functional outcome (modified Rankin Scale score of 4–6 within 1 year of surgery) and compared with that of the intracranial hemorrhage (ICH) score with a z test.ResultsForty-five patients were included (62% men, 7% Caucasian, median age 53 years). Thirty-two patients (71%) had poor functional outcome (median follow-up 4.1 months), which was associated with increased age (P=0.032), bgICH volume (P=0.005), intraventricular hemorrhage severity (P=0.032), National Institutes of Health Stroke Scale (P=0.006), and differential volume overlap (P<0.001). Anatomically, poor outcome was associated with bgICH extension into the anterior limb of the internal capsule (P=0.004), caudate (P=0.042), and temporal lobe (P=0.006). The AUC for differential volume overlap was 0.87 (95% CI: 0.76–0.97), which was higher than chance alone (P<0.001), but statistically similar to that (0.82 (0.71–0.97)) of the ICH score (P=0.545).ConclusionStereotactic bgICH localization enabled functional outcome prognostication in patients undergoing minimally invasive surgical evacuation.

show abstract

The establishment of a 3D anatomical coordinate system for defining vaginal axis and spatial position

Cited by 4 publications

References 31 publications

Vaginal morphology and position associated with prolapse recurrence after vaginal surgery: A secondary analysis of the DEMAND study

Vaginal morphology and position associated with prolapse recurrence after vaginal surgery: A secondary analysis of the DEMAND study

A simplified method for evaluating the anatomical axis of the upper two-thirds of the vagina on MRI: A hospital-based cross-sectional study

Computational modeling of basal ganglia hemorrhage morphology improves functional outcome prognostication after minimally invasive surgical evacuation

Contact Info

Product

Resources

About