Publications by authors named "VanBuren W"

Endometriosis is a chronic systemic condition characterized by the presence of ectopic endometrial-like tissue outside of the uterus. It occurs most often in reproductive-aged patients and less frequently in postmenopausal women. In postmenopausal patients, endometriosis is more common in those undergoing hormone replacement therapy or taking tamoxifen.

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ACR Appropriateness Criteria® Endometriosis.

J Am Coll Radiol

November 2024

Endometriosis is a common condition impacting individuals assigned female at birth. Though incompletely understood, the disorder is caused by endometrial-like tissue located outside of the endometrial cavity, associated with inflammation and fibrosis. Clinical presentation is variable, ranging from asymptomatic to severe pelvic pain and infertility.

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Article Synopsis
  • * Diagnosis may involve imaging techniques like MRI and advanced transvaginal ultrasound, which help identify deep endometriosis and assess associated complications like fibrosis and adhesions.
  • * Radiologists play a crucial role in recognizing the wide range of endometriosis manifestations, including the ability to evaluate features that might indicate malignancy.
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Endometriosis is a common yet morbid disease. Imaging plays an important role in diagnosis and treatment planning. Both ultrasound (US) and MRI are used to detect disease.

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Multiple infiltrative disorders can affect the small bowel, often resulting in diffuse small bowel wall thickening. These infiltrative disorders can manifest owing to various factors such as an influx of immunologic or neoplastic cells or the accumulation of substances within one or more layers of the intestinal wall. Although there can be considerable overlap in the appearances of infiltrative diseases on cross-sectional images, a comprehensive understanding of more specific ancillary imaging features and clinicopathologic correlation can substantially narrow the differential diagnosis.

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Asymptomatic adnexal masses are commonly encountered in daily radiology practice. Although the vast majority of these masses are benign, a small subset have a risk of malignancy, which require gynecologic oncology referral for best treatment outcomes. Ultrasound, using a combination of both transabdominal, transvaginal, and duplex Doppler technique can accurately characterize the majority of these lesions.

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This review focuses on the initial imaging in the reproductive age adult population with acute pelvic pain, including patients with positive and negative beta-human chorionic gonadotropin (β-hCG) levels with suspected gynecological and nongynecological etiology. For all patients, a combination of transabdominal and transvaginal pelvic ultrasound with Doppler is usually appropriate as an initial imaging study. If nongynecological etiology in patients with negative β-hCG is suspected, then CT of the abdomen and pelvis with or without contrast is also usually appropriate.

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Endometriosis is a prevalent and potentially debilitating condition that mostly affects individuals of reproductive age, and often has a substantial diagnostic delay. US is usually the first-line imaging modality used when patients report chronic pelvic pain or have issues of infertility, both common symptoms of endometriosis. Other than the visualization of an endometrioma, sonologists frequently do not appreciate endometriosis on routine transvaginal US images.

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Endometriosis is a common crippling disease in women of reproductive age. Magnetic resonance imaging (MRI) is considered the cornerstone radiological technique for both the diagnosis and management of endometriosis. While its sensitivity, especially in deep infiltrating endometriosis, is superior to that of ultrasonography, many sources of false-positive results exist, leading to a lack of specificity.

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Article Synopsis
  • Endometriosis predominantly affects individuals assigned female at birth, with the primary symptom being pain, often linked to nerve involvement in the condition.* -
  • Pelvic nerves, like the sciatic and pudendal nerves, can be affected, making detailed imaging techniques like high-resolution MRI crucial for identifying nerve entrapment.* -
  • Early detection of nerve involvement is vital to prevent lasting damage and complications, emphasizing the need for radiologists to evaluate and report on affected pelvic nerves during imaging.*
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Background: Endometriosis is a chronic, debilitating condition affecting up to 10% of reproductive-age women. Urinary tract endometriosis is found in 1%-6% of women diagnosed with pelvic endometriosis, with the most common sites being the bladder (70%-85%), ureter (9%-23%), and kidney (4%). Patients typically present with symptoms such as lower abdominal pain, dysuria, and urgency.

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Article Synopsis
  • The study compared the characteristics and outcomes of patients with focal-occult placenta accreta spectrum to those with previa-associated placenta accreta spectrum.
  • A total of 74 cases were reviewed, with 43 being focal-occult and 31 being previa-associated, revealing differences in surgical interventions like hysterectomy rates (25.6% for focal-occult versus 100% for previa).
  • The findings highlighted no significant differences in maternal age, body mass index, or history of prior dilation procedures between the two groups, but noted a higher likelihood of complications and interventions in the previa-associated cases.
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Melanoma is one of the most common types of cancer diagnosed during pregnancy. Patients with advanced disease require frequent staging examinations (e.g.

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ACR Appropriateness Criteria® Fibroids.

J Am Coll Radiol

November 2022

Uterine fibroids (leiomyomas or myomas) are the most common neoplasm of the uterus. Though incompletely understood, fibroid etiology is multifactorial, a combination of genetic alterations and endocrine, autocrine, environmental, and other factors such as race, age, parity, and body mass index. Black women have greater than an 80% incidence of fibroids by age 50, whereas White women have an incidence approaching 70%.

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Study Objective: To highlight different surgical approaches for managing deep infiltrating endometriosis involving the rectosigmoid colon.

Design: Demonstration of specific surgical techniques with educational narrated video footage.

Setting: Bowel endometriosis is reported in 3.

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Article Synopsis
  • The study evaluated the feasibility and safety of percutaneous image-guided cryoablation for treating abdominal wall endometriosis (AWE) in 18 female patients between January 2018 and December 2020.
  • All procedures showed technical success, with 94% of lesions showing no signs of residual disease at follow-up, and 93% of patients reported symptom improvement post-treatment.
  • The study concluded that cryoablation is a safe and effective treatment for AWE, and more long-term studies are needed to assess the durability of results.
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The purpose of this article is to illustrate the benefits of magnetic resonance imaging (MRI) in the setting of abdominopelvic emergencies. Owing to intrinsically high soft-tissue contrast resolution, and ability to resolve different soft tissue, MRI holds notable advantages over other imaging modalities and can be used as a problem-solving tool. Additional advantages of MRI include lack of radiation-related risks to children and pregnant women, and the ability to acquire detailed diagnostic information even without intravenous contrast which can be beneficial in patients with contrast allergy and end-stage renal disease.

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Liver magnetic resonance imaging (MRI) is a commonly performed imaging technique with multiple indications and applications. There are two general groups of contrast agents used when imaging the liver, extracellular contrast agents (ECA) and hepatobiliary agents (HBA), each of which has its own advantages and limitations. Liver MRI with ECA provides excellent information on abdominal vasculature and better quality multi-phasic studies for characterization of focal liver lesions.

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Ovarian borderline tumors are neoplasms of epithelial origin that are typically present in young patients and tend to have a less aggressive clinical course than malignant tumors. Accurate diagnosis and staging of borderline tumors has important prognostic and management implications (like fertility-sparing procedures) for women of child-bearing age. This article will review the sonographic, CT, and MRI features of borderline epithelial ovarian tumors with histopathologic correlation.

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