Clinical application of virtual hysteroscopy by CO 2-multidetector-row computed tomography to submucosal myomas

Abstract

Study objective We produced virtual hysteroscopy (VH) images from the images obtained after expanding the uterine cavity of patients with submucosal myomas and performing multidetector-row computed tomography scans, and assessed them in comparison with hysteroscopic imaging and in relation to the advantages of VH. Design Cohort-control study (Canadian Task Force classification II-2). Setting Tokyo Medical University Hospital department of obstetrics and gynecology. Patients Thirty-one patients with submucosal myomas treated by endoscopic surgery. Measurements and main results The expandability of the uterine cavity by CO 2 gas was favorable in all 31 patients in whom imaging was performed, and it was possible to obtain clear VH images. The sites of origin of the submucosal myomas were clearly visualized; their imaging was consistent with imaging by hysteroscopy; and as a method of establishing the orientation of the uterine cavity, it was possible to obtain a greater amount of information than by hysteroscopy. Conclusion Although the invasiveness of radiation exposure and contrast medium cannot be denied, the possibilities of and indications for VH, which by expanding and visualizing the uterine cavity enables the acquisition of navigation images of the uterine cavity that varies in morphology from patient to patient, are expected to continue to expand.