Artificial intelligence for automated detection of congenital brain anomalies in the first trimester:the Rotterdam Periconception Cohort

Here, we showed the first steps towards automatic detection of brain anomalies in first trimester pregnancies using 3D ultrasound images. The next step is to evaluate if the abnormal features correspond with the brain anomalies. In the future, we will extend this algorithm towards a broader age range and towards all anatomical structures to enable automated congenital anomaly screening during the first trimester

Feasibility of diffusion tensor imaging (DTI) with fibre tractography of the normal female pelvic floor

To prospectively determine the feasibility of diffusion tensor imaging (DTI) with fibre tractography as a tool for the three-dimensional (3D) visualisation of normal pelvic floor anatomy. Five young female nulliparous subjects (mean age 28 ± 3 years) underwent DTI at 3.0T. Two-dimensional diffusion-weighted axial spin-echo echo-planar (SP-EPI) pulse sequence of the pelvic floor was performed, with additional T2-TSE multiplanar sequences for anatomical reference. Fibre tractography for visualisation of predefined pelvic floor and pelvic wall muscles was performed offline by two observers, applying a consensus method. Three eigenvalues (λ1, λ2, λ3), fractional anisotropy (FA) and mean diffusivity (MD) were calculated from the fibre trajectories. In all subjects fibre tractography resulted in a satisfactory anatomical representation of the pubovisceral muscle, perineal body, anal - and urethral sphincter complex and internal obturator muscle. Mean FA values ranged from 0.23 ± 0.02 to 0.30 ± 0.04, MD values from 1.30 ± 0.08 to 1.73 ± 0.12 × 10(-)³ mm²/s. Muscular structures in the superficial layer of the pelvic floor could not be satisfactorily identified. This study demonstrates the feasibility of visualising the complex three-dimensional pelvic floor architecture using 3T-DTI with fibre tractography. DTI of the deep female pelvic floor may provide new insights into pelvic floor disorder

Advances in MRI of the colon and pelvic floor

Er zijn meerdere beeldvormende technieken beschikbaar om de dikke darm te bekijken. Frank Zijta onderzocht onder meer de diagnostische waarde van de MRI-techniek colografie voor het detecteren van dikkedarmafwijkingen. MR-colografie blijkt een nauwkeurige methode voor het opsporen van grote poliepen. Zijta introduceert daarnaast Diffusion Tensor Imaging (DTI) als een nieuwe techniek voor de beoordeling van de vrouwelijke bekkenbodem. DTI met vezeltractografie maakt de driedimensionale visualisatie mogelijk van de spieren van de vrouwelijke bekkenbodem. Met de techniek kan nu echter nog onvoldoende spierschade aangetoond worden

Magnetic resonance (MR) colonography in the detection of colorectal lesions: a systematic review of prospective studies

To determine the diagnostic accuracy of MR-colonography for the detection of colorectal lesions. A comprehensive literature search was performed for comparative MR-colonography studies, published between May 1997 and February 2009, using the MEDLINE, EMBASE and Cochrane databases. We included studies if MR-colonography findings were prospectively compared with conventional colonoscopy in (a)symptomatic patients. Two reviewers independently extracted study design characteristics and data for summarising sensitivity and specificity. Heterogeneity in findings between studies was tested using I (2) test statistics. Sensitivity and specificity estimates with 95% confidence intervals (CI) were calculated on per patient basis and summary sensitivity on per polyp basis, using bivariate and univariate statistical models. Thirty-seven studies were found to be potentially relevant and 13 fulfilled the inclusion criteria. The study population comprised 1,285 patients with a mean disease prevalence of 44% (range 22-63%). Sensitivity for the detection of CRC was 100%. Significant heterogeneity was found for overall per patient sensitivity and specificity. For polyps with a size of 10 mm or larger, per patient sensitivity and specificity estimates were 88% (95% CI 63-97%; I (2) = 37%) and 99% (95% CI 95-100%; I (2) = 60%). On a per polyp basis, polyps of 10 mm or larger were detected with a sensitivity of 84% (95% CI 66-94%; I (2) = 51%). The data were too heterogeneous for polyps smaller than 6 mm and 6-9 mm. MR-colonography can accurately detect colorectal polyps more than 10 mm in siz

Abdominal Tuberculosis Complicated by Intestinal Perforation

Although relatively rare, there is an increasing incidence of abdominal tuberculosis (TB) in the developed countries, with the peritoneum being the most common site of involvement. Manifestation of abdominal TB should be considered in patients with relevant clinical symptoms and risk factors, including a history of prior TB infection and residence in or travel to an area where tuberculosis is endemic. We report a case of intestinal tuberculosis with a complicated disease course after the completion of treatment. Persisting abdominal symptoms during or after treatment should raise suspicion of subclinical intestinal obstruction. Early clinical recognition and surgical treatment may avoid poor outcome due to intestinal perforation

Diffusion tensor imaging and fiber tractography for the visualization of the female pelvic floor

In the past decade, the evaluation of the pelvic support for understanding pelvic floor dysfunction by means of magnetic resonance imaging (MRI) has been an emerging area of research. Both static and dynamic MRI techniques have been effectively applied as a diagnostic resource to reveal abnormalities to the muscular pelvic support, but fail to unravel the precise pathophysiology of this complex disorder. Diffusion tensor imaging (DTI) and tractography comprise enhanced MRI techniques that enable the three-dimensional visualization of anisotropic tissue, such as muscle fibers, and provide a quantitative description of tissue organization and integrity. Quantifying DTI and fiber tractography might be able to reveal microstructural abnormalities in the pelvic support that are not noticeable using conventional MRI techniques. In this article, we discuss relevant anatomy, the current state of DTI and tractography in the evaluation of the female pelvic floor, and their potential future clinical application

Acute Abdominal Pain Caused by an Infected Mesenteric Cyst in a 24-Year-Old Female

A mesenteric cyst is a rare cause for abdominal pain. This umbrella term includes cystic entities which reside in the mesentery. We present a case of an infected false mesenteric cyst in a 24-year-old female patient without prior surgery or known trauma. Mainstay of treatment involves surgical resection, although less invasive treatments have been described. Prognosis depends on the origin of the cyst