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The Value of Transvaginal Sonography Performed before Diagnostic Hysteroscopy for the Evaluation of Uterine Cavity in Infertile Women

Author: Lilyan W. Sersam
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 4 Pages: 276-285
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Hysteroscopy have gained general acceptance as a method for the investigation of infertility. The main advantage of hysteroscopy is the capability of inspecting the uterine cavity. Transvaginal sonography (TVS) is a noninvasive modality that provide excellent imaging of the uterus and of endometrial abnormalities. The present study was designed to evaluate the use of TVS as the initial diagnostic procedure before hysteroscopy for detecting intrauterine disorders.METHODS:Seventy-eight infertile women were examined by TVS and diagnostic hysteroscopy in the late follicular phase of the menstrual cycle and the results were compared.RESULTS:The uterine cavity abnormalities were present in 19.2% of the infertile females involved in the study. The Transvaginal sonography had 87.5% sensitivity, 100% specificity for detecting endometrial polyps while it had 100% sensitivity and 100% specificity for detecting other intrauterine cavity abnormalities including intrauterine adhesions, uterine septae and submucosal myomas.CONCLUSION:Examination of the uterine cavity is an integral part of any thorough evaluation of an infertile woman. Transvaginal sonography, when performed during the follicular phase, can detect most uterine cavity abnormalities. It was an accurate tool in the identification of intrauterine adhesions, uterine septae and submucosal fibroids.


Article
Comparison between Transvaginal Sonography and Magnetic Resonance Imaging Study Findings in Patient with Endometrial Carcinoma

Authors: Fowz Adnan Yaser --- Ausama Ayaad Al-Bayati
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 4 Pages: 640-648
Publisher: Babylon University جامعة بابل

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Abstract

The main objective of this study is to compare between the findings that obtained from both TVS and MRI study in diagnosis of endometrial carcinoma and differentiate it from other endometrial pathology and to assess the accuracy of both techniques in evaluation and detection of myometrium invasion. This prospective study was done in AL- Hilla Teaching Hospital from August 2016 to August 2017 on (22) patients, their ages were from 46-79 years old, (18) of them are postmenopausal and (4) patients are premenopausal, all of them were suffering from recurrent dysfunctional vaginal bleeding. Patients are examined by both TVS and MRI study with contrast endometrial carcinoma is suggested and histopathology insisted the diagnosis, comparison between two techniques is reported.By TVS (7) of the patients have bulky size uterus with different endometrial masses size and texture, other (15) patients have just irregular increase in endometrial thickness. Myometrial invasion which is the most important prognostic factor was as follows: (2) patients have no distinct invasion, (7) patients have less than 1/3 myometrial invasion, (9) patients have more than 2/3 of myometrial invasion; in comparison with enhanced MRI study; findings were that (13) of patients have well defined different sizes and intensity masses, (9) patients have irregular increase in endometrial thickness with different degree of myometrial invasion, myometrial invasion was as follows: (9) patients with less than 1/3 of myometrial invasion, (9) patients with more than 2/3 of myometrial invasion, (2) patients the invasion reaching to serosa and involving the cervix. The conclusions from this imaging assumes increasing importance in the management of patients with endometrial carcinoma in recent years. Transvaginal sonography that performed by expert specialist can be consider a feasible, economic imaging modality with diagnostic accuracy comparable to that of MRI in preoperative local staging of endometrial cancer. Dynamic contrast enhanced MRI study is more accurate in diagnosis and evaluation of endometrial carcinoma and assessment of myometrial invasion. Early disease detection and accurate staging provide optimal management and minimize mortality and morbidity.

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