Трехмерная эхография в оценке степени облитерации полости матки

Abstract

Objective. To improve treatment outcomes for intrauterine adhesions (IUA) in reproductive-aged patients by implementing an algorithm of three-dimensional (3D) ultrasound diagnostics. Patients and methods. This study included 146 women with suspected IUA. The mean age of patients was 30.7 ± 3.4 years. All patients were retrospectively divided into 5 groups: Group 0 (n = 27) – patients with thin endometrium; group I (n = 29) – patients with grade 1 IUA; group II (n = 22) – patients with grade 2 IUA; group III (n = 37) – patients with grade 3 IUA; group IV (n = 31) – patients with grade 4-5 IUA. The control group consisted of 20 healthy women. Algorithms for using different functions and modes of 3D ultrasound to assess the degree and architectonics of IUA were practiced. Results. Qualitative (polygonal shape of the uterine cavity, invagination of myometrium into the endometrium, fragmentary/total endometrial absence) and quantitative (dynamic examination of endometrial volume) ultrasound criteria defining the degree of IUA in 3D ultrasound according to the ESGE classification were developed. Conclusion. Based on the developed 3D ultrasound criteria, the algorithm and criteria for diagnosing the degree of IUA were established. The analysis of intrauterine architectonics allowed prediction of the course and choice of adhesiolysis technique and to reduce the number of intraoperative complications. Key words: 3D ultrasound, intrauterine adhesions, myomectomy, Asherman’s syndrome, uterine artery embolization, echohysterography