The Endomyometrial Thickness Measurement for Abnormal Implantation Evaluation by Pelvic Sonography

Lewiss, Resa E.; Shaukat, Nadia Maria; Saul, Turandot

doi:10.7863/ultra.33.7.1143

Cited by 19 publications

(13 citation statements)

References 19 publications

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“…If the POCUS is suggestive of an ectopic pregnancy (tubal ring, adnexal mass, pseudogestational sac, free fluid in the abdomen, endometrial mantle measuring less than 5–8 mm concerning for an interstitial pregnancy), patients should undergo urgent ultrasonography by imaging specialists and gynecology consultation [271, 272]. …”

Section: Diagnostic Applications Of Ultrasoundmentioning

confidence: 99%

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

et al. 2016

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The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers. To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed “how to” and description of individual point-of-care ultrasound examinations. Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.

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Section: Diagnostic Applications Of Ultrasoundmentioning

confidence: 99%

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

et al. 2016

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“…Although a myometrial mantle measurement less than 5 mm and located lateral to the round ligament have been reported as two important indicators of interstitial pregnancy [ 1 , 30 ], we excluded these two image features in our diagnostic model. Similar to the results of our study, Tulandi and Al-Jaroudi argue that a thin myometrial mantle is not an important sign to distinguish the interstitial pregnancy from an eccentrically located intrauterine pregnancy [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

The role of three-dimensional MRI in the differentiation between angular pregnancy and interstitial pregnancy

Gao

Sun

2022

BMC Pregnancy Childbirth

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Background In clinical practice it is an ongoing challenge to distinguish between angular pregnancy and interstitial pregnancy. With the three-dimensional (3D) magnetic resonance imaging (MRI) being increasingly used, it is worth exploring its role in differentiating angular pregnancy from interstitial pregnancy. This study aims to investigate how 3D MRI can help reveal the differences between these two special pregnancies in the early diagnosis. Methods We reviewed and analyzed the 3D MRI images of 50 patients with interstitial pregnancy and 55 patients with angular pregnancy retrospectively. Imaging features were identified to compare these two special pregnancies, and the ROC (Receiver Operating Characteristic) analysis was conducted to assess the diagnostic performance. Results The significant differences of the 3D MRI imaging features between interstitial pregnancy and angular pregnancy were found in the outline of uterus cavity (p < 0.001), involvement of junctional zone (p < 0.001), the signal of surroundings (p = 0.005), the relationship with round ligament (p = 0.042), and the overlying myometrial thickness (p = 0.041). Furthermore, the multivariate logistic regression analysis identified a series of significant indicators for angular pregnancy, including the junctional zone involvement, being-surrounded by hyper/iso-intensity on 3D images, and the asymmetric outline of uterus cavity. Combining these three imaging features, the AUC (Area under the Curve) of ROC curve was 0.87 in distinguishing interstitial pregnancy from angular pregnancy. Conclusions This study suggests that 3D MRI can help distinguish angular pregnancy from interstitial pregnancy in clinical practice, with the advantages that conventional MRI or ultrasound does not have. Through the significant image features, 3D MRI plays an important role in improving the timing of diagnosis, avoiding unnecessary interventions, and preventing hemorrhage in clinical practice.

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“…Differentiating interstitial from angular pregnancies has proven difficult despite advances of 3D sonography and MRI. A myometrial mantle measurement of <5 mm, in addition to a gestational sac separate from the endometrium, is often denoted as indicative of an interstitial pregnancy despite low specificity [ 15 , 16 ]. However, a 2017 retrospective review of 44 interstitial and angular pregnancies found that myometrial thickness <5 mm was present in 96% of interstitial pregnancies but also 50% of angular pregnancies (range 3–8 mm) [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Angular vs. interstitial pregnancy: A case report highlighting diagnostic nuances with stark management differences

Marfori

Kotzen

2018

Case Reports in Women's Health

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BackgroundIn the literature, the terms “angular”, “interstitial” and “cornual” have often been inappropriately interchanged. The consequence is under-recognition of their differences as well as inaccurate imaging guidelines which do not reliably distinguish them as distinct entities. Angular pregnancies should be considered viable and may be managed to term.CaseA woman at 7w5d was transferred for surgical management of a presumed interstitial ectopic pregnancy. Sonography and MRI confirmed an eccentric fundal pregnancy with a thin myometrial mantle of 2–5 mm; the diagnosis of interstitial pregnancy was favored. Upon laparoscopy, the round ligament was displaced lateral to the pregnancy bulge and the diagnosis of angular pregnancy was thus apparent. The pregnancy was continued to term and delivered via repeat cesarean section without incident.ConclusionAngular and interstitial pregnancies are different entities which cannot always be reliably distinguished via imaging alone. Diagnostic laparoscopy may be a final step in determining pregnancy location. Angular pregnancies should be considered potentially viable and may be managed to term.

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The Endomyometrial Thickness Measurement for Abnormal Implantation Evaluation by Pelvic Sonography

Cited by 19 publications

References 19 publications

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

The role of three-dimensional MRI in the differentiation between angular pregnancy and interstitial pregnancy

Angular vs. interstitial pregnancy: A case report highlighting diagnostic nuances with stark management differences

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