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[en] Objective: To evaluate the imaging appearances of abdominally retained crumpled gauze with US, CT and MRI and the changes with time. Methods: Eight rabbits were operated and crumpled gauze was put into in their abdominal cavity. US , plain and enhanced CT and MRI scan were performed on the day of operation, and 1 to 7 weeks after operation. The imaging appearances were compared with operation findings. Pathologic examination was done simultaneously. Results: Abdominally retained crumpled gauze was instantly adhesive with omentum and neighboring intestines tightly. Fibro-connective tissue membrane was produced at the adhesion site gradually, spreading out to enclose the crumpled gauze. The enclosure was finished completely in 3 to 4 weeks. Thickened membrane also invaded into the spaces within the gauze. The crumpled gauze was eventually infected. These changes could be revealed on US, CT or MRI scans. The US appearance exhibited a hyper echoic arc zone with broad clean acoustic shadow behind. It appeared as a soft tissue mass to CT and MRI scans. In early stage CT scan could easily show the gas within the crumpled gauze. CT and MRI enhanced scans showed only the enhanced membrane and no enhancement of the crumpled gauze. Conclusion: US, CT and MRI have quite characteristic appearances of the abdominally retained crumpled gauze, especially when combined imaging techniques were employed, which can lead to a correct diagnosis together with a history of operation
[en] Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.