Role of Three-Dimensional Ultrasound in Gynecology

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Three-dimensional ultrasound offers high accuracy for diagnosing gynecological conditions like uterine anomalies, fibroids, and pelvic floor issues, proving beneficial in routine workups.

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This paper reviews three-dimensional ultrasound (3D USG) and its applications in gynecology, describing its performance for congenital uterine anomalies, intrauterine lesions, adnexal masses, urogynecologic anatomy, and pelvic-floor assessment, including comparisons with magnetic resonance imaging and laparoscopy. It reports that 3D USG can provide more sensitive and specific mapping of uterine lesions than two-dimensional ultrasound and that combining 3D USG with saline infusion sonography can address limitations in thin endometria, while noting that for cancer-related and vascular uses there is no consensus on limitations and effectiveness. A caveat emphasized is the lack of agreement across studies regarding clinical use, success, and constraints for some indications. The paper discusses adenomyosis within the context of 3D sonographic lesion mapping and also includes deep endometriosis studies in the references, relating it to endometriosis and adenomyosis research in the gynecologic imaging workflow. This paper is centrally about endometriosis and adenomyosis only in the sense that it summarizes 3D ultrasound performance for uterine lesions including adenomyosis and cites three-dimensional ultrasound studies for deep endometriosis.

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Abstract

Three-dimensional ultrasound (3D USG) is a fast-evolving imaging technique that holds a great potential for use in gynecology. Its sensitivity and specificity is reported to be close to 100 % for diagnosing congenital uterine anomalies, comparable with those of magnetic resonance imaging (MRI) and laparoscopy. With 3D USG, a coronal view of the uterus can be obtained, clearly outlining the external contour of the uterus and providing accurate information about the shape of the cavity. Although 3D USG may not perform well in thin endometria, combining it with saline infusion sonography (SIS) overcomes this problem. Research shows that 3D USG is more sensitive and specific than two-dimensional ultrasound (2D USG) in defining and mapping uterine lesions, such as fibroids, adenomyosis, and intrauterine synechia. In cases of suspected malignancy, 3D USG is mainly used in the initial evaluation of patients. Measuring various indices and mapping vascular architecture with 3D power Doppler have been proposed for evaluating adnexal masses. Although some studies raised hope, no consensus is reached about its use, success, and limitations. In urogynecology, translabial 3D USG is proved to be a valuable tool, as it provides instant access to the axial plane, which clearly depicts the relationship of the vagina, urethra, rectum, and the muscular pelvic floor. Studies report no significant differences between translabial 3D USG and MRI measurements for evaluation of the pelvic floor. In conclusion, adding 3D USG to routine gynecological workup can be beneficial for clinicians, as it provides fast and accurate results in a relatively cost-effective setting.
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Abstract

Three-dimensional ultrasound (3D USG) is a fast-evolving imaging technique that holds a great potential for use in gynecology. Its sensitivity and specificity is reported to be close to 100 % for diagnosing congenital uterine anomalies, comparable with those of magnetic resonance imaging (MRI) and laparoscopy. With 3D USG, a coronal view of the uterus can be obtained, clearly outlining the external contour of the uterus and providing accurate information about the shape of the cavity. Although 3D USG may not perform well in thin endometria, combining it with saline infusion sonography (SIS) overcomes this problem. Research shows that 3D USG is more sensitive and specific than two-dimensional ultrasound (2D USG) in defining and mapping uterine lesions, such as fibroids, adenomyosis, and intrauterine synechia. In cases of suspected malignancy, 3D USG is mainly used in the initial evaluation of patients. Measuring various indices and mapping vascular architecture with 3D power Doppler have been proposed for evaluating adnexal masses. Although some studies raised hope, no consensus is reached about its use, success, and limitations. In urogynecology, translabial 3D USG is proved to be a valuable tool, as it provides instant access to the axial plane, which clearly depicts the relationship of the vagina, urethra, rectum, and the muscular pelvic floor. Studies report no significant differences between translabial 3D USG and MRI measurements for evaluation of the pelvic floor. In conclusion, adding 3D USG to routine gynecological workup can be beneficial for clinicians, as it provides fast and accurate results in a relatively cost-effective setting. Similar content being viewed by others

References

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Conflict of Interest The authors declare no conflict of interest. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Turkgeldi, E., Urman, B. & Ata, B. Role of Three-Dimensional Ultrasound in Gynecology. J Obstet Gynecol India 65, 146–154 (2015). https://doi.org/10.1007/s13224-014-0635-z Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s13224-014-0635-z

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