Clinical Research
Analysis of the diagnosis and missed diagnosis of intrauterine adhesions by three-dimensional transvaginal sonography Render and tomographic ultrasound imaging
Ye Qin, Xue Ensheng, Liang Rongxi, Guo Jingjing, Lin Xueying, Wang Yan
Published 2020-03-25
Cite as Chin J Ultrasonogr, 2020,29(03): 255-259. DOI: 10.3760/cma.j.cn131148-20190812-00478
Abstract
ObjectiveTo investigate the value of three-dimensional transvaginal sonography(3D-TVS) in the diagnosis of intrauterine adhesions(IUA) and to analyze the causes of the missed diagnosis.
MethodsForty-seven patients with IUA were examined by three-dimensional transvaginal sonography(3D-TVS), 3D volume imaging (Render imaging) and tomographic ultrasound imaging(TUI imaging) in the Union Hospital of Fujian Medical University from January 2017 to July 2019. The abnormal echo data of the endometrium were recorded and analyzed, and the ultrasound diagnosis and hysteroscopic diagnosis were compared.
Results3D-TVS correctly diagnosed IUA was accurate in the 39 cases whose ultrasound imaging showed an uneven thickness of endometrial echo with the uterine cavity line having different degrees of echo continuity interruption. The diagnostic accuracy rate was 83.0%(39/47). In the Render imaging, 7 cases showed endometrial echo with honeycomb change, 28 cases showed partial echo loss with irregular low echo zone or low echo, and 4 cases showed corneal disappearance of one side. In TUI imaging, the endometrium was partly thinned in varying degrees where echo continuity was interrupted with hypoechoic band-like changes in all 39 cases. Three of the 8 missed IUA cases showed slender endometrium with filiform or membranous adhesions, and the other 5 were patients with uterine endometrial polyps.
Conclusions3D-TVS, Render imaging and TUI imaging technology can display stereo images, which contributes to the better preoperative diagnosis and postoperative follow-up. Care should be taken to avoid missed diagnosis and to improve the diagnostic accuracy for IUA by the techniques.
Key words:
Ultrasonography, transvaginal, three-dimensional; Intrauterine adhesions
Contributor Information
Ye Qin
Department of Ultrasound, Union Hospital, Fujian Medical University, Fujian Institute of Ultrasonic Medicine, Fuzhou 350001, China
Xue Ensheng
Department of Ultrasound, Union Hospital, Fujian Medical University, Fujian Institute of Ultrasonic Medicine, Fuzhou 350001, China
Liang Rongxi
Department of Ultrasound, Union Hospital, Fujian Medical University, Fujian Institute of Ultrasonic Medicine, Fuzhou 350001, China
Guo Jingjing
Department of Ultrasound, Union Hospital, Fujian Medical University, Fujian Institute of Ultrasonic Medicine, Fuzhou 350001, China
Lin Xueying
Department of Ultrasound, Union Hospital, Fujian Medical University, Fujian Institute of Ultrasonic Medicine, Fuzhou 350001, China
Wang Yan
Department of Ultrasound, Union Hospital, Fujian Medical University, Fujian Institute of Ultrasonic Medicine, Fuzhou 350001, China