OP16.03: The use of 3D power Doppler ultrasound in the quantification of blood vessels in uterine fibroids; feasibility and reproducibility

Abstract

Short oral presentation abstracts20-25o respectively. Volumes were stored and posteriorly reviewed by different experienced sonographers, who classified the volumes as satisfactory or not for fetal echocardiography performance. The final diagnosis was compared to second trimester echocardiography or necropsy in cases of termination of the pregnancy. Results: A total of 135 fetuses were included in the study. The indication for fetal echo was reversed ductus venosus ''a'' wave (32.8%), maternal drug exposure (21.6%), family history of congenital heart defects (14.2%), increased nuchal translucency (13.4%), maternal diabetes (10.4%) or other fetal conditions (7.4%). Mean gestational age at sonographic evaluation was 13.3 weeks (11.6-14.1). A final diagnosis was possible in 129 fetuses (96.3%). There were 5 major CHD. 4 were correctly detected with STIC (1 aortic coarctation, 1 Ebstein, 1 hypoplastic left ventricle and 1 tetralogy of Fallot (TOF)), while one was missed (TOF), corresponding to a not satisfactory STIC volume. There were two false positive and negative diagnosis for minor abnormalities: aberrant right subclavian artery and muscular ventricular septal defect. Overall 4D-STIC sensitivity for major CHD was 80%, with 100% specificity, positive and negative predictive values. Total accuracy in reassuring normality or CHD diagnosis was 96.1% (124/129). Conclusions: Although the number of affected cases is small to draw strong conclusions, our study suggest that offline analysis of first trimester 4D-STIC volumes is a reliable tool for normality reassurance and to diagnose most major CHD at 11-14 weeks gestation. OP16: ABNORMAL BLEEDING OP16.01Reproducibility of 3D-transvaginal sonography by VCI analysis to differentiate endometrial polyp and hyperplasia in pre-menopausal women F. Leone, F. Parisi, C. Marciante, A. Crepaldi, C. Lanzani, S. de Meo, I. Cetin Department of Obstetrics and Gynecology, DSC L. Sacco, Milan, ItalyObjectives: To analyze the reproducibility of 3D-transvaginal sonography (3D-TVS) by Volume Contrast Imaging (VCI) analysis in the differential diagnosis of endometrial polyp and hyperplasia in pre-menopausal women among examiners with different level of expertise. Methods: 50 pre-menopausal women with abnormal uterine bleeding and/or infertility scheduled for hysteroscopy were consecutively recruited. 3D-TVS was performed during the early (day 5-9 -Group A) and late (day 10-14 -Group B) proliferative phase of the cycle and 3D volumes of the uterus were acquired and stored. Directed office hysteroscopic endometrial biopsy was considered the gold standard. Four examiners, with different levels of experience, evaluated the 3D stored volumes by multiplanar display and VCI analysis (by two millimeters slices). The presence of hyperechoic areas within hypoechoic proliferative endometrium was considered suspicious for endometrial hyperplasia; the presence of a hyperechoic lesion with the bright edge was considered suspicious for endometrial polyp. To analyze intra-observer agreement each examiner...

An investigation of endometrial vascularity in normally menstruating women and those in other physiological states using 3D ultrasound imaging

“…1,2 Three-dimensional (3D) power Doppler ultrasound has been established as a reproducible tool in the assessment of vascularization and has indeed been used to measure the vascularization of the endometrium. 3,4 However, vascularization is rarely used in routine clinical settings as part assessment of the endometrium. It has been established from previous studies that changes in the vasculature can serve as a predictor of various conditions such as implantation failure following assisted reproduction and miscarriages.…”

“…This vasculature, regulated by hormones such as progesterone and estrogen, is crucial for normal endometrial function especially receptivity 1,2 . Three‐dimensional (3D) power Doppler ultrasound has been established as a reproducible tool in the assessment of vascularization and has indeed been used to measure the vascularization of the endometrium 3,4 . However, vascularization is rarely used in routine clinical settings as part assessment of the endometrium.…”