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Mervak BM, Sakala MD. Beyond the AJR: In Utero Exposure to Gadolinium-Based Contrast Agents May Not Increase Rates of Stillbirth or Neonatal Death or ICU Admission. AJR Am J Roentgenol 2023; 221:280. [PMID: 36598097 DOI: 10.2214/ajr.22.28891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Benjamin M Mervak
- Department of Radiology, Michigan Medicine, 1500 E Medical Center Dr, Ann Arbor, MI 48109
| | - Michelle D Sakala
- Department of Radiology, Michigan Medicine, 1500 E Medical Center Dr, Ann Arbor, MI 48109
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Maturen KE, Shampain KL, Roseland ME, Sakala MD, Zhang M, Stein EB. Malignant Epithelial Tumors of the Ovary. Radiol Clin North Am 2023; 61:563-577. [PMID: 37169424 DOI: 10.1016/j.rcl.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Epithelial ovarian neoplasms (EON) constitute the majority of ovarian cancers. Among EON, high-grade serous carcinoma (HGSC) is the most common and most likely to present at an advanced stage. Radiologists should recognize the imaging features associated with HGSC, particularly at ultrasound and MR imaging. Computed tomography is used for staging and to direct care pathways. Peritoneal carcinomatosis is common and does not preclude surgical resection. Other less common malignant EON have varied appearances, but share a common correlation between the amount of vascularized solid tissue and the likelihood of malignancy.
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Sakala MD, Jha P, Tong A, Taffel MT, Feldman MK. MR Imaging of Endometriosis of the Adnexa. Magn Reson Imaging Clin N Am 2022; 31:121-135. [DOI: 10.1016/j.mric.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Bell SG, Uppal S, Sakala MD, Sciallis AP, Rolston A. An extrauterine extensively metastatic epithelioid trophoblastic tumor responsive to pembrolizumab. Gynecol Oncol Rep 2021; 37:100819. [PMID: 34258359 PMCID: PMC8258853 DOI: 10.1016/j.gore.2021.100819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 02/07/2023] Open
Abstract
We report on a case of epithelioid trophoblastic tumor that responded to pembrolizumab. Epithelioid trophoblastic tumor is the rarest variant of gestational trophoblastic disease. Immune checkpoint inhibitors are gaining popularity in patients with gestational trophoblastic disease.
We report a case of extrauterine epithelioid trophoblastic tumor (ETT)—the rarest variant of gestational trophoblastic tumor—that has been stable on nearly two years of pembrolizumab treatment. A 47-year-old gravida 2, para 2 who underwent a prophylactic bilateral salpingo-oophorectomy nine years prior and bilateral mastectomy five years prior in the setting of a strong family history of breast and ovarian cancer with no genetic testing performed, presented to an outside clinic with recurrent respiratory infections without resolution despite antibiotics. Radiology and pathology testing confirmed the ETT diagnosis, including a second opinion from the John I. Brewer Trophoblastic Disease Center of Northwestern University’s Feinberg School of Medicine, and the patient was started on a chemotherapy regimen of etoposide, methotrexate, actinomycin-D, etoposide, and cisplatin for seven cycles, with partial improvement in her disease. After PD-L1 testing showed the tumor had > 5% PD-L1 positivity, she initiated pembrolizumab in April 2019. CT imaging after three months revealed decreased lung, abdominal, and pelvic disease and she was continued on pembrolizumab. As of December 2020, she had completed 29 cycles of pembrolizumab, with a plan for her to continue treatment indefinitely given her decreased, but persistent, disease. Our findings suggest pembrolizumab is a reasonable option for treatment of patients with significant PD-L1 positivity on testing of the tumor.
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Affiliation(s)
- Sarah G Bell
- University of Michigan Department of Obstetrics and Gynecology, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA
| | - Shitanshu Uppal
- University of Michigan Department of Obstetrics and Gynecology, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA
| | - Michelle D Sakala
- University of Michigan Department of Radiology, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA
| | - Andrew P Sciallis
- University of Michigan Department of Pathology, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA
| | - Aimee Rolston
- University of Michigan Department of Obstetrics and Gynecology, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA
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Sevco TJ, Sakala MD. Testicular Tumor Causing Gynecomastia and Fibrocystic Changes. Journal of Breast Imaging 2020. [DOI: 10.1093/jbi/wbaa061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Tyler J Sevco
- University of Michigan, Department of Radiology, Ann Arbor, MI
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Sakala MD, Curci NE, Masch WR, Mendiratta-Lala M, Stein EB, Wasnik AP, Sciallis AP, Uppal S, Pearlman MD, Maturen KE. Radiologic-Histopathologic Correlation of Transvaginal US and Risk-reducing Salpingo-oophorectomy for Women at High Risk for Tubo-ovarian Carcinoma. Radiol Imaging Cancer 2020; 2:e190086. [PMID: 33778746 DOI: 10.1148/rycan.2020190086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 05/28/2020] [Accepted: 06/24/2020] [Indexed: 11/11/2022]
Abstract
Purpose To examine radiologic-histopathologic correlation and the diagnostic performance of transvaginal US prior to risk-reducing salpingo-oophorectomy (RRSO) in women at high risk for tubo-ovarian carcinoma (TOC). Materials and Methods This retrospective study included 147 women (mean age, 49 years; age range, 28-75 years) at high risk for TOC who underwent transvaginal US within 6 months of planned RRSO between May 1, 2007, and March 14, 2018. Histopathologic results were reviewed. Fellowship-trained abdominal radiologists reinterpreted transvaginal US findings by using standardized descriptors. Descriptive statistical analysis and multiple logistic regression were performed. Results Of the 147 women, 136 had mutations in BRCA1, BRCA2, Lynch syndrome, BRIP1, and RAD51D genes, and 11 had a family history of TOC. Histopathologic reports showed 130 (88.4%) benign nonneoplastic results, 10 (6.8%) benign neoplasms, five (3.4%) malignant neoplasms, and two (1.4%) isolated p53 signature lesions. Transvaginal US results showed benign findings in 95 (64.6%) women and abnormal findings in 11 (7.5%) women; one or both ovaries were not visualized in 41 (27.9%) women. Hydrosalpinx was absent in all TOC and p53 signature lesions at transvaginal US. Transvaginal US had 20% sensitivity (one of five), 93% specificity (132 of 142), 9% positive predictive value (one of 11), and 97% negative predictive value (132 of 136) for TOC. Cancer was detected in one of five women at transvaginal US, and three of five false-negative lesions were microscopic or very small. Conclusion Preoperative transvaginal US had low sensitivity for detecting TOC in women at high risk for TOC. Clinically relevant precursors and early cancers were too small to be detected.Keywords: Genital/Reproductive, UltrasoundSupplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
- Michelle D Sakala
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
| | - Nicole E Curci
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
| | - William R Masch
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
| | - Mishal Mendiratta-Lala
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
| | - Erica B Stein
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
| | - Ashish P Wasnik
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
| | - Andrew P Sciallis
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
| | - Shitanshu Uppal
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
| | - Mark D Pearlman
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
| | - Katherine E Maturen
- Departments of Radiology (M.D.S., N.E.C., W.R.M., M.M.L., E.B.S., A.P.W., K.E.M.), Pathology (A.P.S.), and Obstetrics/Gynecology (S.U., M.D.P., K.E.M.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5326
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Abstract
This article focuses on advanced MR imaging techniques of the female pelvis and clinical applications for benign and malignant disease. General and abbreviated protocols for female pelvic MR imaging are reviewed. Diffusion-weighted imaging, dynamic contrast-enhanced MR imaging, and susceptibility-weighted imaging are discussed in the context of adnexal mass characterization using the ADNEx-MR scoring system, evaluation of endometriosis, local staging of cervical and endometrial cancers, assessment of nodal and peritoneal metastasis, and potential detection of leiomyosarcoma. MR defecography is also discussed regarding evaluation of multicompartmental pelvic floor disorders.
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Affiliation(s)
- Michelle D Sakala
- Department of Radiology, Division of Abdominal Imaging, University of Michigan-Michigan Medicine, University Hospital B1 D502D, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Kimberly L Shampain
- Department of Radiology, Division of Abdominal Imaging, University of Michigan-Michigan Medicine, University Hospital B1 D502D, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Ashish P Wasnik
- Department of Radiology, Division of Abdominal Imaging, University of Michigan-Michigan Medicine, University Hospital B1 D502D, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
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Neal CH, Sakala MD, Houck GE, Noroozian M, Kazerooni EA, Davenport MS. Improving Breast MR Wait Times: A Model for Transitioning Newly Implemented Diagnostic Imaging Procedures into Routine Clinical Operation. J Am Coll Radiol 2018; 15:859-864. [DOI: 10.1016/j.jacr.2018.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 02/05/2018] [Indexed: 10/17/2022]
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Sakala MD, Oliphant M, Anthony EY. Bright Red Rectal Bleeding: The Bottom Line from Neonates to Older Adults. Radiographics 2018. [DOI: 10.1148/rg.2016160063.pres] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Shankar PR, Kaza RK, Al-Hawary MM, Masch WR, Curci NE, Mendiratta-Lala M, Sakala MD, Johnson TD, Davenport MS. Impact of Clinical History on Maximum PI-RADS Version 2 Score: A Six-Reader 120-Case Sham History Retrospective Evaluation. Radiology 2018; 288:158-163. [PMID: 29664338 DOI: 10.1148/radiol.2018172619] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose To assess the impact of clinical history on the maximum Prostate Imaging Recording and Data System (PI-RADS) version 2 (v2) score assigned to multiparametric magnetic resonance (MR) imaging of the prostate. Materials and Methods This retrospective cohort study included 120 consecutively selected multiparametric prostate MR imaging studies performed between November 1, 2016, and December 31, 2016. Sham clinical data in four domains (digital rectal examination, prostate-specific antigen level, plan for biopsy, prior prostate cancer history) were randomly assigned to each case by using a balanced orthogonal design. Six fellowship-trained abdominal radiologists independently reviewed the sham data, actual patient age, and each examination while they were blinded to interreader scoring, true clinical data, and histologic findings. Readers were told the constant sham histories were true, believed the study to be primarily investigating interrater agreement, and were asked to assign a maximum PI-RADS v2 score to each case. Linear regression was performed to assess the association between clinical variables and maximum PI-RADS v2 score designation. Intraclass correlation coefficients (ICCs) were obtained to compare interreader scoring. Results Clinical information had no significant effect on maximum PI-RADS v2 scoring for any of the six readers (P = .09-.99, 42 reader-variable pairs). Distributions of maximum PI-RADS v2 scores in the research context were similar to the distribution of the scores assigned clinically and had fair-to-excellent pairwise interrater agreement (ICC range: 0.53-0.76). Overall interrater agreement was good (ICC: 0.64; 95% confidence interval: 0.57, 0.71). Conclusion Clinical history does not appear to be a substantial bias in maximum PI-RADS v2 score assignment. This is potentially important for clinical nomograms that plan to incorporate PI-RADS v2 score and clinical data into their algorithms (ie, PI-RADS v2 scoring is not confounded by clinical data).
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Affiliation(s)
- Prasad R. Shankar
- From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.)
| | - Ravi K. Kaza
- From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.)
| | - Mahmoud M. Al-Hawary
- From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.)
| | - William R. Masch
- From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.)
| | - Nicole E. Curci
- From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.)
| | - Mishal Mendiratta-Lala
- From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.)
| | - Michelle D. Sakala
- From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.)
| | - Timothy D. Johnson
- From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.)
| | - Matthew S. Davenport
- From the Departments of Radiology (P.R.S., R.K.K., M.M.A., W.R.M., N.E.C., M.M., M.D.S., M.S.D.) and Urology (M.S.D.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1-D530H, Ann Arbor, MI 48109; and Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich (T.D.J.)
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Sakala MD, Carlos RC, Mendiratta-Lala M, Quint EH, Maturen KE. Understanding Patient Preference in Female Pelvic Imaging: Transvaginal Ultrasound and MRI. Acad Radiol 2018; 25:439-444. [PMID: 29241597 DOI: 10.1016/j.acra.2017.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/07/2017] [Accepted: 10/08/2017] [Indexed: 10/18/2022]
Abstract
RATIONALE AND OBJECTIVES Women with pelvic pain or abnormal uterine bleeding may undergo diagnostic imaging. This study evaluates patient experience in transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) and explores correlations between preference and symptom severity. MATERIALS AND METHODS Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act-compliant prospective study. Fifty premenopausal women with pelvic symptoms evaluated by recent TVUS and MRI and without history of gynecologic cancer or hysterectomy were included. A phone questionnaire used validated survey instruments including Uterine Fibroid Symptoms Quality of Life index, Testing Morbidities Index, and Wait Trade Off for TVUS and MRI examinations. RESULTS Using Wait Trade Off, patients preferred TVUS over MRI (3.58 vs 2.80 weeks, 95% confidence interval [CI] -1.63, 0.12; P = .08). Summary test utility of Testing Morbidities Index for MRI was worse than for TVUS (81.64 vs 87.42, 95%CI 0.41, 11.15; P = .03). Patients reported greater embarrassment during TVUS than during MRI (P <.0001), but greater fear and anxiety both before (P <.0001) and during (P <.001) MRI, and greater mental (P = .02) and physical (P = .02) problems after MRI versus TVUS. Subscale correlations showed physically inactive women rated TVUS more negatively (R = -0.32, P = .03), whereas women with more severe symptoms of loss of control of health (R = -0.28, P = .04) and sexual dysfunction (R = -0.30, P = .03) rated MRI more negatively. CONCLUSION Women with pelvic symptoms had a slight but significant preference for TVUS over MRI. Identifying specific distressing aspects of each test and patient factors contributing to negative perceptions can direct improvement in both test environment and patient preparation. Improved patient experience may increase imaging value.
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Sakala MD, Oliphant M, Anthony EY. Bright Red Rectal Bleeding: The Bottom Line from Neonates to Older Adults: Gastrointestinal Imaging. Radiographics 2016; 36:1600-1. [DOI: 10.1148/rg.2016160063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Affiliation(s)
- Rafel Tappouni
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC.
| | - Michelle D Sakala
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC
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Affiliation(s)
- Michelle D Sakala
- Department of Radiology, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
| | - Raymond B Dyer
- Department of Radiology, Wake Forest Baptist Medical Center, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA
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Sakala MD, Dillman JR, Ladino-Torres MF, McHugh JB, Adler J. MR enterography of ileocolovesicular fistula in pediatric Crohn disease. Pediatr Radiol 2011; 41:663-7. [PMID: 21076822 DOI: 10.1007/s00247-010-1896-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 09/29/2010] [Accepted: 10/15/2010] [Indexed: 12/15/2022]
Abstract
Crohn disease, a form of chronic inflammatory bowel disease is characterized by discontinuous inflammatory lesions of the gastrointestinal tract, has a variety of behavioral patterns, including penetrating or fistulous disease. While magnetic resonance enterography (MRE) excellently depicts inflamed bowel segments, it can also be used to assess for a variety of Crohn-disease-related extraintestinal complications, including fistulae. We present the MRE findings of a complex ileocolovesicular fistula in a 14-year-old boy with Crohn disease, where the fistulous tract to the urinary bladder was best delineated on precontrast T1-W imaging because of the presence of fecal material.
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