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Correlations from gadopentetate dimeglumine-enhanced magnetic resonance imaging after methotrexate chemotherapy for hemorrhagic placenta increta.

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Title: Correlations from gadopentetate dimeglumine-enhanced magnetic resonance imaging after methotrexate chemotherapy for hemorrhagic placenta increta.
Authors: Wehbe, Salim A.1 selimw@hotmail.com, Ghulmiyyah, Labib M.1 labloub@hotmail.com, Carroll, Kenneth T.2 carr3822@bellsouth.net, Perloe, Mark3 mperloe@ivf.com, Schwartzberg, Daniel G.4 dendl@comcast.net, Sills, E. Scott3 dr.sills@ivf.com
Source: BioMagnetic Research & Technology. 2003, Vol. 1, p3-5. 5p. 3 Diagrams.
Subjects: Methotrexate, Magnetic resonance imaging, Hemorrhage, Placenta, Transvaginal ultrasonography
Abstract: Objective: To describe pre- and post-methotrexate (MTX) therapy images from pelvic magnetic resonance imaging (MRI) with gadopentetate dimeglumine contrast following chemotherapy for post-partum hemorrhage secondary to placenta increta. Material and method: A 28-year-old Caucasian female presented 4 weeks post-partum complaining of intermittent vaginal bleeding. She underwent dilatation and curettage immediately after vaginal delivery for suspected retained placental tissue but 28 d after delivery, the serum β-hCG persisted at 156 IU/mL. Office transvaginal sonogram (4 mHz B-mode) was performed, followed by pelvic MRI using a 1.5 Tesla instrument after administration of gadolinium-based contrast agent. MTX was administered intramuscularly, and MRI was repeated four weeks later. Results: While transvaginal sonogram suggested retained products of conception confined to the endometrial compartment, an irregular 53 x 34 x 28 mm heterogeneous intrauterine mass was noted on MRI to extend into the anterior myometrium, consistent with placenta increta. Vaginal bleeding diminished following MTX treatment, with complete discontinuation of bleeding achieved by ~20 d post-injection. MRI using identical technique one month later showed complete resolution of the uterine lesion. Serum β-hCG was <5 IU/mL. Conclusion: Reduction or elimination of risks associated with surgical management of placenta increta is important to preserve uterine function and reproductive potential. For selected hemodynamically stable patients, placenta increta may be treated non-operatively with MTX as described here. A satisfactory response to MTX can be ascertained by serum hCG measurements with pre- and post-treatment pelvic MRI with gadopentetate dimeglumine enhancement, which offers advantages over standard transvaginal sonography. [ABSTRACT FROM AUTHOR]
Copyright of BioMagnetic Research & Technology is the property of BioMed Central and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Correlations from gadopentetate dimeglumine-enhanced magnetic resonance imaging after methotrexate chemotherapy for hemorrhagic placenta increta.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wehbe%2C+Salim+A%2E%22&quot;&gt;Wehbe, Salim A.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; selimw@hotmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ghulmiyyah%2C+Labib+M%2E%22&quot;&gt;Ghulmiyyah, Labib M.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;i&gt; labloub@hotmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Carroll%2C+Kenneth+T%2E%22&quot;&gt;Carroll, Kenneth T.&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;i&gt; carr3822@bellsouth.net&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Perloe%2C+Mark%22&quot;&gt;Perloe, Mark&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;&lt;i&gt; mperloe@ivf.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Schwartzberg%2C+Daniel+G%2E%22&quot;&gt;Schwartzberg, Daniel G.&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt;&lt;i&gt; dendl@comcast.net&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sills%2C+E%2E+Scott%22&quot;&gt;Sills, E. Scott&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;&lt;i&gt; dr.sills@ivf.com&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Methotrexate%22&quot;&gt;Methotrexate&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Magnetic+resonance+imaging%22&quot;&gt;Magnetic resonance imaging&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hemorrhage%22&quot;&gt;Hemorrhage&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Placenta%22&quot;&gt;Placenta&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Transvaginal+ultrasonography%22&quot;&gt;Transvaginal ultrasonography&lt;/searchLink&gt;
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  Label: Abstract
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  Data: Objective: To describe pre- and post-methotrexate (MTX) therapy images from pelvic magnetic resonance imaging (MRI) with gadopentetate dimeglumine contrast following chemotherapy for post-partum hemorrhage secondary to placenta increta. Material and method: A 28-year-old Caucasian female presented 4 weeks post-partum complaining of intermittent vaginal bleeding. She underwent dilatation and curettage immediately after vaginal delivery for suspected retained placental tissue but 28 d after delivery, the serum β-hCG persisted at 156 IU/mL. Office transvaginal sonogram (4 mHz B-mode) was performed, followed by pelvic MRI using a 1.5 Tesla instrument after administration of gadolinium-based contrast agent. MTX was administered intramuscularly, and MRI was repeated four weeks later. Results: While transvaginal sonogram suggested retained products of conception confined to the endometrial compartment, an irregular 53 x 34 x 28 mm heterogeneous intrauterine mass was noted on MRI to extend into the anterior myometrium, consistent with placenta increta. Vaginal bleeding diminished following MTX treatment, with complete discontinuation of bleeding achieved by ~20 d post-injection. MRI using identical technique one month later showed complete resolution of the uterine lesion. Serum β-hCG was &lt;5 IU/mL. Conclusion: Reduction or elimination of risks associated with surgical management of placenta increta is important to preserve uterine function and reproductive potential. For selected hemodynamically stable patients, placenta increta may be treated non-operatively with MTX as described here. A satisfactory response to MTX can be ascertained by serum hCG measurements with pre- and post-treatment pelvic MRI with gadopentetate dimeglumine enhancement, which offers advantages over standard transvaginal sonography. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of BioMagnetic Research &amp; Technology is the property of BioMed Central and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1186/1477-044X-1-3
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      – Code: eng
        Text: English
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      – SubjectFull: Methotrexate
        Type: general
      – SubjectFull: Magnetic resonance imaging
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      – SubjectFull: Hemorrhage
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      – SubjectFull: Placenta
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              Text: 2003
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