Gynecologic ultrasonography: recent advances and research in various technical modalities

Abstract

This paper reviews clinical research in gynecologic sonography, focussing on uterine cavity lesions, endometrial abnormalities and adnexal masses (including endometriosis), and ectopic pregnancy. For each topic, detection of sonographic pathologic features and sonographic mode are discussed, as well as the latest applications of sonodiagnostic methods, and relevant topics in clinical research. A new approach to evaluation of sonographic structures can be seen, including for borderline mucinous and serous ovarian tumors, in mean gray value, evaluation of grade of tissue echogenicity, evaluation of intact endometrial midline echo in ectopic pregnancy, and application of gel instillation sonography. Novel sonographic three-dimensional modalities, such as virtual navigation through three orthogonal planes, multislice tomosonography, volumetry by a virtual organ computer-aided analysis system, three-dimensional power Doppler, and space reconstruction of structures enable gynecologic diagnoses to be made more exactly. Clinical research investigates different sonographic features in benign and malignant gynecologic pathology. For studies of typical signs of benign uterine fibroids, endometrial volume, and vascularization of malignant endometrial tumors, as well as typical benign adnexal structures, the ovarian crescent sign were performed. At this time, no exact sonographic features for distinguishing between benign and malignant gynecologic tumors are available.