Gynecology
From imaging to clinical diagnosis
3D ultrasound in gynecology, a technique accessible to all and for a precise diagnosis
The 2D ultrasound brought us the indispensable sagittal cutting and the axial cutting. But 3D ultrasound has brought us the essential element for diagnosis in many pathologies: the front cut.
So we can wonder about the lack of knowledge of 3D ultrasound imaging, despite its indisputable effectiveness, and often its diagnostic superiority over MRI. The technique is simple, fast, almost robotic on medium-range ultrasound machines.
It is time to systematize the gynecological ultrasound examination by integrating the three cuts: Sagittal, axial and frontal.
This small atlas is not exhaustive, but wants to be a contribution to the soon to be systematized gynecological ultrasound examination, in the service of diagnosis and therapeutic sanction. The contribution of sonography also seems essential to the accuracy of the diagnosis: but again, how many sonographies are made when the 2D ultrasound is not solvable?
Vascularization in the junction zone and in the feet of the vegetation, of a type that is encorbellant and penetrating.
Coronal Cup in HDlive sonography, whose representation of the vegetation is close to the hysteroscopic image.
Congenital Malformations: in these 4 cases, it is type U2a. The sonography associated with the frontal cutting is the true pre-operative cutting:
- the base of the spur is well cleared from the isthmus (1 and 4);
- its possible deviation to one of the myometrial walls to be reported to the surgeon (3);
- the rigidity of the two hemi-cavities which leads to poor distensibility (2).
Sagittal and coronal cross-section boards of myom locations. The Sagittal Cup of the Figo is not enough, the Coronal Cup that we have added to the report gives essential information to the surgeon.
3D ultrasound combining the sagittal section on the left and the true coronal section on the right, obtained in "OmniView". It allows to visualize the cervix, isthmus and cavity, as well as the myometer endpoint junction area.
Hypertrophy - sonography. This diagnostic step makes it possible to clearly show the heterogenicity of the hypertrophy, which is not present on all the contours of the cavity.
Hypertrophy. Axial cut in surfacing mode.
Hypertrophy. Coronal cut in thick cut.
Representing a coronal cut during a sonography. Structures with an irregular border, but with little angle and a clear area of junction with the myometer.
Sonography in triplane mode. Many vegetative structures, associated with atrophy zones.
Diagnostic sequence of a polyp.
- Sagittal cut: loss of hyperechogenic median echo.
- Coronal Cup: 2 tones are identified, without breaking a clear junction zone between the endometrial and myometer.
- Sagittal cross-section sonography associated with the color doppler.
- Type 4 Vascularization in subendometrial and myometrial, and many vessels in the intracavitarian structure without hypertrophy.Thick cuts in coronal.
Adénomyose. Sagittal cuts showing on the one hand the hypertrophy of the bottom.
Adénomyose. Coronal Cup: even more demonstrative of the hypertrophy of the bottom and the appearance in the radius.
The sonography, in the case of adenomyosis, shows on the coronal section the disappearance of the peripheral hypoechogenic halo to the cavity and the small glandular crypts of the bottom, which "take the water".
Topic diagnostic sequence A synchesis in the context of an infertility check. The triplane cross-section indicates interruptions of the hyperechogenic median echo. The coronal cross-section sonography shows the passage of physiological serum to ostias. This is the information the surgeon is waiting for: the ostias are free.
Isthmocle wide, long deep, but myometrial wall remains thick.
Bilateral Position 3. The Essure® moved into the trumpet, left the pore portion. Classic salpingography, or better, XemGel injection should be performed in search of possible permeability.
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