Diagnostic Imaging of the Female Pelvis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 January 2025 | Viewed by 4949

Special Issue Editors


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Guest Editor
Department of Radiology, Ospedale Centrale di Bolzano, 39100 Bolzano, Italy
Interests: magnetic resonance; computed tomography; imaging; diagnostic imaging; medical imaging; diagnostic radiology; ultrasound imaging; clinical imaging; medical image analysis
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Guest Editor
Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
Interests: magnetic resonance; computed tomography; diagnostic imaging; diagnostic radiology

Special Issue Information

Dear Colleagues,

For many decades, pelvic imaging has been poorly explored, mainly because of the technical limitations that made it difficult to obtain good quality images, and surgical exploration was required for diagnosing and staging most pelvic pathologies. Nowadays, thanks to the rapid technical developments that enabled us to obtain high-quality diagnostic images that accurately depict the pelvic content, pelvic imaging has become a cornerstone in differential diagnosis, preoperative planning, and extension evaluation of almost every pelvic disease.

In comparison to the male pelvis, the female pelvis is characterized by a more complex anatomy and is associated with a wider spectrum of benign, and malignant pathologies. Moreover, female pelvic structures undergo important changes during the life cycle.

The aim of this Special Issue is to illustrate the state-of-the-art in the imaging of the female pelvis, for benign and malignant, structural and functional, pathologies, in order to help radiologists and gynecologists in their everyday clinical practice.

Dr. Matteo Bonatti
Dr. Giacomo Avesani
Guest Editors

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Published Papers (2 papers)

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Research

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17 pages, 4066 KiB  
Article
Quantitative 3D Analysis of Levator Ani Muscle Subdivisions in Nulliparous Women: MRI Feasibility Study
by Nathalie Moser, Stephan Skawran, Klaus Steigmiller, Barbara Röhrnbauer, Thomas Winklehner, Cäcilia S. Reiner and Cornelia Betschart
Diagnostics 2024, 14(9), 923; https://doi.org/10.3390/diagnostics14090923 - 29 Apr 2024
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Abstract
Background: The levator ani muscle (LAM) is crucial for pelvic floor stability, yet its quantitative MRI assessment is only a recent focus. Our study aims to standardize the quantitative analysis of the LAM morphology within the 3D Pelvic Inclination Correction System (3D-PICS). Methods: [...] Read more.
Background: The levator ani muscle (LAM) is crucial for pelvic floor stability, yet its quantitative MRI assessment is only a recent focus. Our study aims to standardize the quantitative analysis of the LAM morphology within the 3D Pelvic Inclination Correction System (3D-PICS). Methods: We analyzed 35 static MR datasets from nulliparous women examining the pubovisceral (PVM), iliococcygeal (ICM), coccygeal (COC), and puborectal muscle (PRM). The PVM consists of three origin-insertion pairs, namely the puboanal (PAM), puboperineal (PPM) and pubovaginal muscle (PVaM). The analysis included a quantitative examination of the morphology of LAM, focusing on the median location (x/y/z) (x: anterior–posterior, y: superior–inferior, z: left–right) of the origin and insertion points (a), angles (b) and lengths (c) of LAM. Inter-rater reliability was calculated. Results: Interindividual variations in 3D coordinates among muscle subdivisions were shown. In all, 93% of all origin and insertion points were found within an SD of <8 mm. Angles to the xz-plane range between −15.4° (right PRM) and 40.7° (left PAM). The PRM is the largest pelvic muscle in static MRI. The ICC indicated moderate-to-good agreement between raters. Conclusions: The accurate morphometry of the LAM and its subdivisions, along with reliable inter-rater agreement, was demonstrated, enhancing the understanding of normal pelvic anatomy in young nulliparous women. Full article
(This article belongs to the Special Issue Diagnostic Imaging of the Female Pelvis)
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Review

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16 pages, 9192 KiB  
Review
Abnormal Uterine Bleeding: A Pictorial Review on Differential Diagnosis and Not-So-Common Cases of Interventional Radiology Management
by Sara Viganò, Antonella Smedile, Caterina Cazzella, Paolo Marra, Pietro Andrea Bonaffini and Sandro Sironi
Diagnostics 2024, 14(8), 798; https://doi.org/10.3390/diagnostics14080798 - 11 Apr 2024
Cited by 1 | Viewed by 3228
Abstract
Abnormal uterine bleeding (AUB) poses a multifaceted challenge in women’s health, necessitating an integrated approach that addresses its diverse etiologies and clinical presentations. The International Federation of Gynecology and Obstetrics PALM-COEIN classification system provides a systematic approach to the diagnosis of AUB in [...] Read more.
Abnormal uterine bleeding (AUB) poses a multifaceted challenge in women’s health, necessitating an integrated approach that addresses its diverse etiologies and clinical presentations. The International Federation of Gynecology and Obstetrics PALM-COEIN classification system provides a systematic approach to the diagnosis of AUB in non-pregnant women, based on clinical and imaging-based categorization of causes into structural (Polyps, Adenomyosis, Leiomyomas and Malignancy; PALM), and non-structural causes (Coagulopathies, Ovulatory disorders, primary Endometrial disorders, Iatrogenic and Not otherwise classified; COEIN). On the other hand, placental disorders, uterine rupture, ectopic pregnancy and retained products of conceptions are the main causes of uterine bleeding during pregnancy and in the peripartum period. Ultrasound is usually the first-line imaging technique for the differential diagnosis of causes of AUB. Computed Tomography may be useful if ultrasound findings are unclear, especially in emergency settings. Magnetic resonance imaging, when indicated, is an excellent second-line diagnostic tool for a better non-invasive characterization of the underlying cause of AUB. This pictorial review aims to illustrate the main causes of AUB from the point of view of diagnostic imaging and to show not-so-common cases that can be treated by means of interventional radiology. Full article
(This article belongs to the Special Issue Diagnostic Imaging of the Female Pelvis)
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