A prospective study to evaluate the efficacy of two- and three-dimensional sonohysterography in women with intrauterine lesions

Sylvestre, Camille; Child, Tim; Tulandi, Togas; Tan, Seang Lin

doi:10.1016/s0015-0282(03)00154-7

Cited by 114 publications

(60 citation statements)

References 10 publications

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“…2DSH is currently indicated when TVUS fails to identify the cause of uterine bleeding or when it reveals an abnormality of the uterine cavity that cannot be reliably characterized [11]. 2DSH involves injection of several milliliters of saline into the uterine cavity during TVUS, which distends the walls of the organ and thus facilitates the detection of focal endometrial lesions.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional sonohysterography for examination of the uterine cavity in women with abnormal uterine bleeding: Preliminary findings

Sconfienza

Lacelli

Caldiera

et al. 2010

Journal of Ultrasound

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KEYWORDSSonohysterography; Three-dimensional sonohysterography; Hysteroscopy; Abnormal uterine bleeding.Abstract Introduction: To compare the diagnostic values of three-dimensional sonohysterography (3DSH), transvaginal ultrasound (TVUS), and 2-dimensional sonohysterography (2DSH) in the work-up of abnormal uterine bleeding (AUB), in particular the ability of each method to identify intracavitary lesions arising from the endometrium or uterine wall. Materials and methods: 24 patients referred for AUB underwent TVUS followed by 2-D and 3-D HS in the same session. Three-dimensional data were acquired with a free-hand technique during maximal distention of the uterus. Within 10 days of the sonographic session, each patient underwent hysteroscopy, which was considered the reference standard. For each of the 3 imaging methods, we calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. Results: Hysteroscopy demonstrated the presence of an intrauterine lesion in 21/24 patients (87.5%). In 3/24 patients hysteroscopy was negative. For TVUS, 2DSH, and 3DSH, sensitivity was 76% (16/21), 90% (19/21), 100% (21/21), respectively; specificity was 100% (3/3), 100% (19/19), 100% (21/21); PPV was 100%, 100%, 100%; NPV was 37%, 60%, 100%; accuracy was 76%, 90%, 100%. Conclusions: 3DSH is more sensitive that 2DSH or TVUS in the detection of intrauterine lesions. If these preliminary results are confirmed in larger studies, 3DSH could be proposed as a valuable alternative to diagnostic hysteroscopy.Sommario Introduzione: Valutare l'impatto diagnostico della Isterosonografia Tridimensionale (ISG 3D) nello studio della cavità uterina in donne con sanguinamento anomalo (SUA) rispetto all'ecografia transvaginale (ETV) e all'isterosonografia bidimensionale (ISG 2D), particolarmente per l'identificazione di neoformazioni a sviluppo endocavitario della superficie endometriale e della parete uterina. Materiali e metodi: Ventiquattro pazienti affette da SUA sono state incluse nello studio. Ciascuna di esse é stata sottoposta ad ETV, ISG e ISG 3D durante la medesima seduta. Le acquisizioni 3D sono state ottenute con tecnica free-hand in fase di massima replezione idrica della cavità. Tutte le pazienti sono state valutate con isteroscopia entro 10 giorni dall'ecografia. Considerando l'esame isteroscopico come reference standard, sono stati calcolati i valori di sensibilità, specificità, valore predittivo positivo (VPP), valore predittivo negativo (VPN) ed accuratezza delle tre metodiche. Risultati: L'isteroscopia ha dimostrato la presenza di lesioni endocavitarie in 21/24 pazienti (87,5% . L'ISG 3D ha consentito una completa identificazione dei rapporti delle lesioni con la cavità uterina e con la parete endometriale. Conclusioni: L'ISG 3D è una metodica con maggiore sensibilità nella definizione delle lesioni della cavità uterina rispetto all'ISG 2D ed all'ETV. Se questi dati preliminari saranno confermati da studi piú ampi, ISG 3D potrebbe essere proposta come alternativa all'ister...

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Section: Introductionmentioning

confidence: 99%

Three-dimensional sonohysterography for examination of the uterine cavity in women with abnormal uterine bleeding: Preliminary findings

Sconfienza

Lacelli

Caldiera

et al. 2010

Journal of Ultrasound

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“…In general, however, the sensitivity and specificity of ultrasound in the diagnosis of uterine synechiae remains limited. 22,23 We found a sensitivity of 25%. The interest of 3D ultrasound has been mentioned by these authors.…”

Section: Discussionmentioning

confidence: 60%

Diagnostic, therapeutic and prognostic aspects of uterine synechiae managed by hysteroscopy in the gyanecological endoscopic surgery and human reproductive teaching hospital

Belinga

Tompeen

Ndoua

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Uterine synechiae refers to a total or partial union of the inner walls of the uterus resulting from endometrial trauma. It is a cause of reproductive failure. Until now, synechia was not optimally treated and has remained understudied in Cameroon. Objective of present study was to Evaluate the diagnostic, therapeutic and prognostic aspects of uterine synechiae treated by hysteroscopy.Methods: We conducted a descriptive cross-sectional study with an analytical component from January 1st 2015 to July 31st 2017 at Yaounde. All patients diagnosed with uterine synechiae and treated with hysteroscopy were our sample. Sampling was consecutive. The chi-square test was used for the comparison of qualitative variables and Fisher's test for ANOVA variance analysis. The comparison of the averages was made by the Student's test. P-value less than 0.05 was considered as statistically significant.Results: Hysteroscopies were indicated for uterine synechiae in 14.50%. Nulliparous were 56.67%. A history of curettage/aspiration was present in 66.66%. All of the patients had a form of infertility and 83.33% had menstrual disorders. Hysterosalpingography showed a better sensitivity (88%). After hysteroscopic treatment, 63.30% had a complete anatomical restitution. There is a significant correlation between the stage of severity of synechia and anatomical restitution (p=0.008; Spearman correlation coefficient=-0.477).Conclusions: Uterine synechiae represent one-sixth of all indications for hysteroscopy and present clinically as menstrual disorder associated with infertility. A past history of uterine curettage is common. Hysterosalpingography has a better preoperative diagnostic sensitivity. Hysteroscopy allows optimal treatment.

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“…[9][10][11][12][13][14][15][16][17] Other applications of 3-dimensional sonography of the endometrium include endometrial volume measurements in patients with postmenopausal bleeding, assessment of intracavitary lesions, evaluation of endometrial receptivity during in vitro fertilization, localization of the maximal implantation point during sonographically guided embryo transfer, and use in association with extrauterine gestations. [18][19][20][21][22][23] Recently, 3-dimensional transvaginal sonography of the endometrium has assisted the diagnosis of interstitial and intramural pregnancies. [24][25][26] In these cases, as in our case of a cervical pregnancy, 3-dimensional transvaginal sonography of the endometrium enabled precise depiction of the intact endometrium and the presence of an adjacent gestational sac located within the myometrium or uterine cervix, respectively.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Sonographic Findings of a Cervical Pregnancy

Sherer

Gorelick

Dalloul

et al. 2008

Journal of Ultrasound in Medicine

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cervical pregnancy is an uncommon ectopic pregnancy that accounts for less than 1% of such gestations. 1 This condition is associated with an extremely high risk of massive hemorrhage and previously often required hysterectomy. 1 The current diagnostic modality of this potentially lifethreatening condition is transvaginal sonography, supported at times by magnetic resonance imaging. [2][3][4] The definitive diagnostic imaging feature of a cervical pregnancy is the location of a gestational sac in the cervix in the presence of a closed internal uterine cervical os. [2][3][4][5][6][7] We report the 3-dimensional transvaginal sonographic findings of a cervical pregnancy at 6 weeks' gestation.Received August 8, 2007, Case ReportA 34-year-old woman, gravida 3, para 0, came to the emergency department at State University of New York Downstate Medical Center with mild uterine hemorrhage. Her medical history was unremarkable. The patient had 2 previous spontaneous first-trimester miscarriages. Physical examination revealed a healthy individual. She was afebrile with a blood pressure of 120/78 mm Hg, a pulse of 84 beats per minute, and a respiratory rate of 20 breaths per minute. Her abdomen was soft and nontender, with no peritoneal signs elicited. Bimanual pelvic examination disclosed a soft, mildly enlarged uterus. Both adnexa were normal. The cervix was long and closed and appeared boggy on inspection.Laboratory test results revealed a hemoglobin level of 13.6 g/dL, a hematocrit value of 42%, a white blood cell count of 7.29 × 10 9 /L, and a platelet count of 255 × 10 9 /L.

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A prospective study to evaluate the efficacy of two- and three-dimensional sonohysterography in women with intrauterine lesions

Cited by 114 publications

References 10 publications

Three-dimensional sonohysterography for examination of the uterine cavity in women with abnormal uterine bleeding: Preliminary findings

Three-dimensional sonohysterography for examination of the uterine cavity in women with abnormal uterine bleeding: Preliminary findings

Diagnostic, therapeutic and prognostic aspects of uterine synechiae managed by hysteroscopy in the gyanecological endoscopic surgery and human reproductive teaching hospital

Three-Dimensional Sonographic Findings of a Cervical Pregnancy

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