Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  18 (2024)
Volume  17 (2023)
Volume  16 (2022)
Volume  15 (2021)
Volume  14 (2020)
Volume  13 (2019)
Volume  12 (2018)
Volume  11 (2017)
Volume  10 (2016)
Volume  9 (2015)
Volume  8 (2014)
Volume  7 (2013)
Volume  6 (2012)
Volume  5 (2011)
Volume  4 (2010)
Volume  3 (2009)
Volume  2 (2008)
Volume  1 (2007)
Related articles

VOLUME 14 , ISSUE 2 ( April-June, 2020 ) > List of Articles

REVIEW ARTICLE

Everyday Practice of 2D/3D Vaginal Ultrasound in Reproductive Gynecology

Keywords : 2D/3D ultrasonography, 3D Doppler, Reproductive gynecology

Citation Information : Everyday Practice of 2D/3D Vaginal Ultrasound in Reproductive Gynecology. Donald School J Ultrasound Obstet Gynecol 2020; 14 (2):97-116.

DOI: 10.5005/jp-journals-10009-1640

License: CC BY-NC 4.0

Published Online: 30-07-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

The key point of this review is to evaluate the diagnostic capability of the initial 2D/3D vaginal ultrasound (US) for the most common conditions that have negative impact on the reproductive potential in women. From our experience with 2D/3D transvaginal US as the initial examination in more than 10,000 patients in the last couple of years, we choose specific cases of different pathologies such as fibroids, endometrial polyps, endometrial synechiae, uterine congenital anomalies, polycystic ovaries (PCOs), ovarian follicular monitoring, and endometrial receptivity assessment. Vaginal US is the method of choice for initial examination in evaluation of the reproductive potential in female patients. The 2D vaginal US examination gives only preliminary data, while the 3D vaginal US increases the efficiency and predictive value of the examination. Some pathologies detected on 2D vaginal US such as uterine anomalies, in general, indicate the presence of the anomaly, while 3D vaginal US fully detects the type of uterine anomalies. Doppler techniques bring detection of neovascularization in specific pathologies and give a view of the vascularization in general, which is essential in this field. Combination of 2D and 3D US is a powerful tool in the hands of a gynecologist in everyday practice. Improvement in 3D, 3D Doppler, and power Doppler vaginal US supplemented with new software tools rises the predictive value of US in the diagnosis of female reproductive system pathology and makes it equal with other diagnostic tools such as magnetic resonance imaging. On the contrary, 2D and 3D US examination are less traumatic for the patients and are less expensive.

HTML PDF Share
  1. Abuhamad A. Ultrasound in obstetrics and gynecology a practical approach, Ch. 11. 2014. pp. 333–237.
  2. Kroon B, Johnson N, Chapman M, et al. Australasian CREI consensus expert panel on trial evidence (ACCEPT) group. Australasian CREI consensus expert panel on trial evidence. Aust NZJ, Obstet Gynaecol 2011;51(4):289–295. DOI: 10.1111/j.1479-828X.2011.01300.x.
  3. Munro MG, Critchley HO, Broder MS, et al. The FIGO classification system (“PALM-COEIN”) for causes of abnormal uterine bleeding in non-gravid women in the reproductive years, including guidelines for clinical investigation. Int J Gynaecol Obstet 2011;113(1):3–13. DOI: 10.1016/j.ijgo.2010.11.011.
  4. Wamsteker K, Emanuel MH, de Kruif JH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension 1993. Obstet Gynecol 1993;82(5):736–740.
  5. Van Den Bosch T, Dueholm M, Leone FPG, et al. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the morphological uterus sonographic assessment (MUSA) group. Ultrasound Obstet Gynecol 2015;46(3):284–298. DOI: 10.1002/uog. 14806.
  6. Kamaya A, Yu PC, Lloyd CR, et al. Sonographic evaluation for endometrial polyps the interrupted mucosa sign 2016. J Ultrasound Med 2016;35(11):2381–2387. DOI: 10.7863/ultra.15.09007|0278-4297.
  7. Timmerman D, Verguts J, Konstantinovic ML, et al. The pedicle artery sign based on sonography with color Doppler imaging can replace second-stage tests in women with abnormal vaginal bleeding. Ultrasound Obstet Gynecol 2003;22(2):166–171. DOI: 10.1002/uog.203.
  8. McCluggage WC. A practical approach to the diagnosis of the mixed epithelial and menzeshimallas tumors of the uterus. Mod Ptaholog 2016;29(Supp. 1):578–591.
  9. Vercellini P, Parazzini F, Oldani S, et al. Surgery: adenomyosis at hysterectomy: A study on frequency distribution and patient characteristics. Human Reprod 1995;10(5):1160–1162. DOI: 10.1093/oxfordjournals.humrep.a136111.
  10. Struble J, Reid S, Bedaiwy MA. Adenomyosis: A clinical review of a challenging gynecologic condition. J Minim Invasive Gynecol 2016;23(2):164–185. DOI: 10.1016/j.jmig.2015.09.018.
  11. Cunningham RM, Mindy M, Horrow M, et al. Adenomyosis: a sonographic diagnosis. Radio Graphics 2018;38(5):1576–1589. DOI: 10.1148/rg.2018180080.
  12. Garcia L, Isaacson K. Adenomyosis: review of the literature. J Minim Invasive Gynecol 2011;18(4):428–437. DOI: 10.1016/j.jmig.2011.04.004.
  13. Kepkep K, Tuncay YA, Göynümer G, et al. Transvaginal sonography in the diagnosis of adenomyosis: Which findings are most accurate? Ultrasound Obstet Gynecol 2007;30(3):341–345. DOI: 10.1002/uog.3985.
  14. Exacoustos C, Brienza L, Di Giovanni A, et al. Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology. Ultrasound Obstet Gynecol 2011;37(4): 471–479. DOI: 10.1002/uog.8900.
  15. Kupesic S, Kurjak A. Clinical Application of 3D Sonography. Parthenon Publishing group, 2000. pp. 200057–200059.
  16. Timmerman D, Bosch TVD, Peeraer K. Vascular malformations in the uterus: ultrasonographic diagnosis and conservative management. Euro J Obstet Gynaecol Reprod Biol 2000;92(1):171–178. DOI: 10.1016/S0301-2115(00)00443-7.
  17. Timor-Tritsch IE, Haynes MC, Monteagudo A, et al. Ultrasound diagnosis and management of acquired uterine enhanced myometrial vascularity/arteriovenous malformations. Am J Obstet Gynecol 2016;214(6):731. DOI: 10.1016/j.ajog.2015.12.024.
  18. Fabres C, Aviles G, De La Jara C, et al. The cesarean delivery scar pouch: Clinical implications and diagnostic correlation between transvaginal sonography and hysteroscopy. J Ultrasound Med 2003;22(7):695–700. DOI: 10.7863/jum.2003.22.7.695.
  19. Tulandi T, Cohen A. Emerging manifestations of cesarean scar defect in reproductive-aged women. J Minim Invasive Gynecol 2016;23(6):893–902. DOI: 10.1016/j.jmig.2016.06.020.
  20. Marotta ML, Donnez J, Squifflet J, et al. Laparoscopic repair of post-cesarean section uterine scar defects diagnosed in nonpregnant women. J Minim Invasive Gynecol 2013;20(3):386–391. DOI: 10.1016/j.jmig.2012.12.006.
  21. Amin TN, Saridogan E, Jurkovic D. Ultrasound and intrauterine adhesions: A novel structured approach to diagnosis and management. Ultrasound Obstet Gynecol 2015;46(2):131–139. DOI: 10.1002/uog.14927.
  22. Mais V, Guerriero S, Ajossa S, et al. The efficiency of transvaginal ultrasonography in the diagnosis of endometrioma. Fertil Steril 1993;60(5):776–780. DOI: 10.1016/s0015-0282(16)56275-x.
  23. Kurjak A, Prka M, Arenas JM, et al. Three-dimensional ultrasonography and power Doppler in ovarian cancer screening of asymptomatic peri- and postmenopausal women. Croatian Med J 2005;46(5): 757–764.
  24. Kurjak A, Sparac V, Kupesic S, et al. Three-dimensional ultrasound and three-dimensional power Doppler in the assessment of adnexal masses. The Ultrasound Review of Obstetrics and Gynecology 2001;1(2):167–183. DOI: 10.3109/14722240108500425.
  25. Somigliana E, Ragni G, Benedetti F, et al. Does laparoscopic excision of endometriotic ovarian cysts significantly affect ovarian reserve? insights from IVF cycles. Hum Reprod 2003;18(11):2450–2453. DOI: 10.1093/humrep/deg432.
  26. Deenadayal M, Kadambari, Donthi S, et al. Diagnosing hydrosalpinx by three-dimensional ultrasonography in inversion mode. J Case Rep Images Obstet Gynecol 2017;3:47–50.
  27. Timor-Tritsch IE, Lerner JP, Monteagudo A, et al. Transvaginal sonographic markers of tubal inflammatory disease. Ultrasound Obstet Gynecol 1998;12(1):56–66. DOI: 10.1046/j.1469-0705.1998.12010056.x.
  28. Chan YY, Jayaprakasan K, Zamora J, et al. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update 2011;17(6):761–771. DOI: 10.1093/humupd/dmr028.
  29. Nazzaro G, Locci M, Marilena M, et al. Differentiating between septate and bicornuate uterus: Bi-dimensional and 3-dimensional power Doppler findings. J Minim Invas Gynecol 2014;21(5):870–876. DOI: 10.1016/j.jmig.2014.03.023.
  30. Buttram VC, Gibbons WE. Mulleriananomalies: aproposed classification (an analysis of 144 cases). Fertil Steril 1979;32(1):40–46. DOI: 10.1016/s0015-0282(16)44114-2.
  31. Grimbizis GF, Gordts S, Di Spiezio Sardo A, et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod 2013;28(8):2032–2044. DOI: 10.1093/humrep/det098.
  32. Ludwin A, Ludwin I, Pityński K, et al. Arethe ESHRE/ESGE criteria of female genital anomalies for diagnosis of septate uterus appropriate? Hum Reprod 2014;29(4):867–868. DOI: 10.1093/humrep/deu001.
  33. Grimbizis GF, Di Spiezio Sardo A, Saravelos SH, et al. The thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies. Hum Reprod 2016;31(1):2–7. DOI: 10.1093/humrep/dev2649,10; CUME-201812 and ASRM-20162.
  34. Ludwin A, Martins WP, Nastri CO, et al. Congenital uterine malformation by experts (CUME): better criteria for distinguishing between normal/arcuate and septate uterus? Ultrasound Obstet Gynecol 2018;51(1):101–109. DOI: 10.1002/uog.18923.
  35. ASRM. Uterine septum: a guideline. Fertil Steril 2016;106(3):530–540. DOI: 10.1016/j.fertnstert.2016.05.014.
  36. Swire MN, Castro-Aragon I, Levine D. Various sonographic appearances of the hemorrhagic corpus luteum cyst. Ultrasound Q 2004;20(2):45–58. DOI: 10.1097/00013644-200406000- 00003.
  37. Kurjak A. Ultrasound and the ovarii, vol. 7, London: The Parthenopn publishing Group; 1994. pp. 104–105.
  38. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop 2004 Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81(1):19–25. DOI: 10.1016/j.fertnstert.2003.10.004.
  39. International evidence-based guideline for the assessment and management of polycystic ovary syndrome,” Accessed, 2018, https://www.monash.edu/data/assets/pdf fle/0004/1412644/PCOS-Evidence-Based-Guideline.pdf.
  40. Lam PM, Raine-Fenning N. The role of three-dimensional ultrasonography in polycystic ovary syndrome. Hum Reprod 2006;21(9):2209–2215. DOI: 10.1093/humrep/del161.
  41. Lujan ME, Jarrett BY, Brooks ED, et al. Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume. Hum Reprod 2013;28(5):1361–1368. DOI: 10.1093/humrep/det062.
  42. Franks S, Webber LJ, Goh M, et al. Ovarian morphology is a marker of heritable biochemical traits in sisters with polycystic ovaries. J Clin Endocrinol Metab 2008;93(9):3396–3402. DOI: 10.1210/jc.2008- 0369.
  43. Kupesic S, et al. Sonographic imaging in infertility. Donald School textbook of transvaginal Ultrasound. 1st ed., Jaypee Brothers Medical Publishers(P) Ltd; 2005. pp. 357–383.
  44. Jayaprakasan K, Chan Y, Islam R, et al. Prediction of in vitro fertilization outcome at different antral follicle count thresholds in a prospective cohort of 1,012 women. Fertil Steril 2012;98(3):657–663. DOI: 10.1016/j.fertnstert.2012.05.042.
  45. Ng EH, Chan CC, Yeung WS, et al. Effect of age on ovarian stromal flow measured by three-dimensional ultrasound with power Doppler in Chinese women with proven fertility. Hum Reprod 2004;19(9): 2132–2137. DOI: 10.1093/humrep/deh387.
  46. Chui DK, Pugh ND, Walker SM, et al. Follicular vascularity-the predictive value of transvaginal power Doppler ultrasonography in an in-vitro fertilization programme: a preliminary study. Hum Reprod 1997;12(1):191–196. DOI: 10.1093/humrep/12.1.191.
  47. Kupesic S, Kurjak A. Predictors of IVF outcome by three dimensional ultrasound. Hum Reprod 2002;17(4):950–955. DOI: 10.1093/humrep/17.4.950.
  48. Poehl M, Hohlagschwandtner M, Doerner V, et al. Cumulus assessment by three dimensional ultrasound for in vitro fertilization. Ultrasound Obstet Gynecol 2000;16(3):251–253. DOI: 10.1046/j.14690705.2000.00270.x.
  49. Merce LT, Barco MJ, Kupesic S, et al. 2D and 3D power doppler ultrasound from ovulation to implantation. In: Textbook of perinatal medicine Kurjak A, Chervenak F London: Parthenon Publishing; 2005. p. 51.
  50. Wu HM, Chiang CH, Huang HY, et al. Detection of subendometrial vascularization flow index by three dimensional ultrasound may be useful for predicting pregnancy rate for patients undergoing in vitro fertilization-embryo transfer. Fertil Steril 2003;79(3):507–511. DOI: 10.1016/S0015-0282(02)04698-8.
  51. Kupesic S, Bekavac I, Bjelos D, et al. Assessment of endometrial receptivity by transvaginal colour doppler and three dimensional power doppler ultrasonography in patients undergoing in vitro fertilization procedures. J Ultrasound Med 2001;20(2):125–134. DOI: 10.7863/jum.2001.20.2.125.
  52. Maubon A, Faury A, Kapella M, et al. Uterine junctional zone at magnetic resonance imaging: a predictor of in vitro fertilization implantation failurejog_. J Obstet Gynaecol Res 2010;36(3):611–618. DOI: 10.1111/j.1447-0756.2010.01189.x.
  53. Ng EHY, Chan CCW, Tang OS, et al. The role of endometrial and subendometrial blood flows measured by three dimensional power doppler ultrasound in prediction of pregnancy during IVF treatment. Hum Reprod 2006;21(1):164–170. DOI: 10.1093/humrep/dei277.
  54. Lazzarin N, Exacoustos C, Vaquero E, et al. Uterine junctional zone at three-dimensional transvaginal ultrasonography in patients with recurrent miscarriage: A new diagnostic tool? Eur J Obstet Gynecol Reprod Biol 2014;174:128–132. DOI: 10.1016/j.ejogrb.2013.12.014.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.