Value Of Transvaginal Sonography Research Articles

Value of Transvaginal Sonography in Antenatal Management of Ectopic Pregnancy

Introduction: Ectopic pregnancy is a high-risk condition which can lead to mortality and morbidity if not diagnosed and managed promptly. Transvaginal Sonography (TVS) has a major role in diagnosing ectopic pregnancy. Certain signs if identified accurately on TVS examination can help predict or exclude ectopic pregnancy precisely.
 Aims & Objectives: To determine the diagnostic accuracy of TVS examination in detecting ectopic pregnancy. It also aims to highlight the need of TVS examination in routine antenatal care during early pregnancy.
 Place and duration of study: The study was carried out at Shaikh Zayed Hospital, Lahore with the collaborated effort of Radiology Department and Department of Gynae & Obs. It was conducted over the period of three years from 1-1- 2017 to 31-12-2019.
 Material & Methods: In this observational study 160 women with suspected ectopic pregnancy were evaluated with ? - HCG levels and TVS examinations. Per-operative findings were taken as the gold standard for patients who underwent laparoscopy/laparotomy, and a trend of ?-HCG for patients with expectant/medical managements per RCOG guidelines. Statistical analyses were applied to find out diagnostic accuracy of TVS findings. The prospective study pattern with close follow-ups and a managing protocol according to the guidelines were required to reinforce the results.
 Results: The sensitivity of TVS in diagnosing Ectopic Pregnancies (EPs) in clinically suspected patients were found to be 92.5%, specificity 84.62%, positive predictive value 94.91%, negative predictive value 78.57% and accuracy rate was calculated as 90.62%. Most frequent signs present were empty uterine cavity, blob sign and embryo with or without cardiac activity.
 Conclusion: TVS examination is quite effective in predicting and excluding ectopic pregnancy in early gestation. Majority of patients with ectopic pregnancy had surgery as part of their management.

The Clinical Value of Transvaginal Sonography Combined with Magnetic Resonance Imaging in Diagnosis of Deep Invasive Endometriosis in Pelvic Cavity

Objective: The objective of this study is to analyze the diagnostic value of transvaginal sonography (TVS), magnetic resonance imaging (MRI) and their combination in patients with deep invasive endometriosis (DIE) in pelvic cavity. Method: In this study, 235 patients with DIE were selected as the study objects, and the lesion location of the patients was determined by TVS, MRI, and combined examination before surgery. According to the actual situation of the patient, laparoscopic or open surgery was performed to remove the lesion tissue, which was regarded as the gold standard. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of TVS, MRI, and combined diagnosis were compared. In addition, Kappa test was adopted to compare the consistency between different diagnostic methods and the gold standard. Results: The total Se of the DIE detected by THV was 91.61%, and the Sp was 90.74%. The total Se of DIE detected by MRI was 95.76%, and the Sp was 92.07%. The total Se of DIE detected by THV combined with MRI was 96.47%, and the Sp was 93.41%. The LR– value of DIE detected by TVS was 0.21, the LR– value detected by MRI was 0.18, and the LR– value detected by combined detection was 0.13. The κ coefficient of DIE detected by TVS was 0.70, the κ coefficient detected by MRI was 0.73, and the κ coefficient by combined detection was 0.79. Conclusion: TVS combined with MRI to detect DIE has a higher sensitivity and specificity, a higher positive detection rate, and a higher consistency with the diagnostic results of gold standard.

Ultrasonography in the prediction of complications during and after uterine myomectomy

This study aims to evaluate the value of transvaginal sonography in the prediction of complications during and after myomectomy. Retrospective analysis of hysteroscopic, laparoscopic, and laparotomic myomectomies are called groups 1, 2, and 3, respectively, between January 2009 and August 2011. For each case, four ultrasonographic characteristics were collected: volume, vascularization, location, and presence of calcification(s). Outcome parameters were surgical time, intraoperative blood loss, embolisms, duration of hospital stay, pre- and postoperative hemoglobin, visceral damage (bladder, bowel, or uterus), fever, secondary hemorrhage, blood transfusion, and second-look surgery. Two-hundred ninety-five cases of hysteroscopic, 60 cases of laparoscopic, and 41 cases of laparotomic myomectomy were analyzed. The overall complication rates were 11.86, 16.67, and 36.59 %, respectively. In group 1, we found an association between volume and surgery time, blood loss, length of hospital stay, gas embolism, second-look surgery, and the risk of one or more complications. Myomas with volumes of 40 ml or more showed a higher complication rate than myomas with lower volumes. Higher vascularization correlated with more blood loss during surgery. In group 2, the volume of the myoma correlated with the difference between pre- and postoperative hemoglobin and hospital stay. In group 3, the number of removed myomas was a predictor for the length of hospital stay, the need for blood transfusion, and the risk on one or more complications. Transvaginal sonography can be used in the prediction of complications during and after myomectomy. In case of hysteroscopic or laparoscopic resection, the volume of the myoma is a significant predictor of complications. In case of laparotomic resection, the number of myomas that has to be removed is a predictor for the risks of complications.

Combined transvaginal sonography and diagnostic hysteroscopy in the assessment of tubal patency in infertile women in correlation to laparoscopic chromopertubation

ObjectiveThe aim of this study was to investigate the diagnostic value of transvaginal sonography (TVS) performed after office hysteroscopy, for assessing tubal patency in subfertile women, and to compare the findings with those obtained with laparoscopic chromopertubation.Study designThis was a cro

Value of transvaginal sonography in assessing severe pelvic endometriosis

Value of transvaginal sonography in assessing severe pelvic endometriosis

OP30.12: The diagnostic value of transvaginal sonography compared to hysteroscopy in endometrial polyp and submucous fibroid detection

OP30.12: The diagnostic value of transvaginal sonography compared to hysteroscopy in endometrial polyp and submucous fibroid detection

P12.07: The value of transvaginal sonography in surgical evacuation of retained products of conception

P12.07: The value of transvaginal sonography in surgical evacuation of retained products of conception

Sonographische Bestimmung der Infiltrationstiefe beim Endometriumkarzinom

Purpose: Myometrial invasion depth of endometrial cancer is an important prognostic factor. Preoperative assessment is decisive for appropriate surgical treatment. The aim of the study is to assess the value of transvaginal sonography (TVS) for determining the myometrial invasion depth in endometrial cancer. Material and Methods: In 214 patients with endometrial cancer (118 patients before and 96 other patients after dilatation and curettage (D&C]), the myometral invasion depth (greater than 50% or less than 50%) was measured preoperatively. The maximum endometrial height (twice the thickness) was measured sonographically. The maximum endometrial height (E) was set in relation to the anterior-posterior diameter of the uterus (U). A myometrial invasion depth of greater than 50% was assumed with E/U >0.5. An invasion which was limited to the inner half of the myometrium was represented as E/U <=0.5. The sonographic results were compared to the histopathological findings. Results: A sensitivity of 92% and a positive predictive value of 74% were obtained for invasion depths of greater than 50%. In 13% of the cases the invasion depth was overestimated while in only 3% it was underestimated. The diagnostic accuracy in both groups was equivalent: 83% for TVS before D&C and 85% for TVS after D&C. Conclusion: TVS is a valuable, non-invasive diagnostic method for patients with endometrial cancer. If TVS data are combined with results from other preoperative tests, the obtained prognostic information provides a useful basis for choosing the appropriate therapy.

The value of transvaginal sonography with and without saline instillation in the diagnosis of uterine pathology in pre- and postmenopausal women with abnormal bleeding or suspect sonographic findings.

In this prospective study, 139 patients, 83 premenopausal patients with abnormal uterine bleeding and 56 postmenopausal patients either with metrorrhagia (33) or a suspect sonographic finding (23), were examined preoperatively with transvaginal sonography (TVS) and saline contrast hysterosonography (SCHS). The histological results, obtained by hysteroscopy, were compared with the preoperative findings. Uterine pathology (benign polyps, submucous fibroids, endometrial hyperplasia and carcinoma) was found in 74.7% and 76.8% of the pre- and postmenopausal patients, respectively. TVS and SCHS are very sensitive at diagnosing uterine pathology, the latter being more specific and enabling better surgical management and a reduction in unnecessary interventions.

Surgery in postmenopausal women ? the value of transvaginal sonography

Transvaginal sonography is a recent addition to the diagnostic techniques available for the evaluation of the female pelvis. Transvaginal sonography is performed with a high-frequency transducer placed in the vagina where it is in close anatomic proximity to the pelvic structures. The procedure overcomes difficulties in imaging obese patients, those with a large amount of bowel gas, and those with inadequate bladder filling. Our experience in over 200 cases of postmenopausal women is the subject of this review. This technique has been employed to detect ovarian and adnexal abnormalities, endometrial changes (hyperplasia and endometrial carcinoma), myometrial invasion, fibroids, adnexal torsion and free fluid in the rectouterine fossa. The results suggest that transvaginal sonography has considerable advantages in the evaluation of pelvic structures in postmenopausal women prior to planned surgical exploration.

Endometrial abnormalities: evaluation with transvaginal sonography

The value of transvaginal sonography in detecting gynecologic disease currently is being defined. To evaluate transvaginal depiction of the endometrium, transvaginal sonograms were compared with conventional transabdominal scans in 29 patients whose sonograms revealed endometrial abnormalities. The two techniques were compared for image quality and ability to provide unique diagnostic information. Sonographic findings included fluid collections (16), thickened and/or echogenic endometria (10), endometrial irregularities (two), and echogenic foci (two). Clinical diagnoses included early intrauterine pregnancies (five), pseudogestational sacs of ectopic pregnancy (one), intrauterine contraceptive devices (two), endometrial carcinoma (one), and intrauterine synechiae with amenorrhea (Asherman syndrome) (two). In most cases (77%), diagnostic information was obtainable by either transabdominal or transvaginal sonograms, although in 23% transvaginal scanning provided unique diagnostic information not available with the transabdominal technique. In no case did transabdominal sonography contribute diagnostic information not provided transvaginally. The quality of the transvaginal image was judged to be better than that of the transabdominal image in 63% of cases; image quality was the same in 33% of cases and worse in 3% of cases. The results show that transvaginal sonography is often superior to transabdominal scanning in the evaluation of endometrial abnormalities. Transvaginal sonography may be the preferred technique in these cases.