A NEW APPROACH: 3D DOPPLER AND STRAIN SONOELASTOGRAPHY INTEGRATION IN THE FEMALE PELVIS ULTRASONOGRAPHY Aristida Colan-Georges
[email protected]
Pan Med Laboratories, Craiova, Romania
Most illustrations in use for the female pelvis: Doppler is still used as an optional/complementary technique
Wade, R, Bliss, S. Diagnostic Ultrasonography in Gynecology. Glob. libr. women's med., (ISSN: 1756-2228) 2008; DOI 10.3843/GLOWM.10075
Most illustrations in use for the female pelvis: Doppler is still a research technique
AbdElkhalek Y, Mansour M, Farouk O. Three dimensional transvaginal sonography and power Doppler angiography in the differentiation between endometrial hyperplasia and endometrial carcinoma in postmenopausal women with abnormal uterine bleeding. Egyptian J. of Rad. and Nuclear Medicine, ISSN: 0378-
603X, Vol: 47, Issue: 4, Page: 1795-1801, 2016
Objectives: ❖ Coupling the aspects of the anatomy with the physiology or their abnormal presentation in the female pelvis using: • Doppler color 3D and spectral • Strain Sonoelastography
❖ Promoting this integrative concept: • In the non-invasive diagnosis (infertility, malignancies) • In the monitoring of cases in tumors, infertility, endocrinopathies, etc.
Material and methods: ➢ A retrospective analysis of 344 consecutive patients ➢ Aged 16 - 81-year-old, examined between Aug. 2014- Dec. 2017 ➢ Patients referred from Endocrine, Gynecological or Oncological Services ➢ Transabdominal convex 4D probe and a transvaginal probe with SE and 3D Doppler software ➢ The results were related to the clinical, biological and pathological reports
Results: I. BASIC DOPPLER AND STRAIN SE IN THE
PHYSIOLOGICAL CHANGES OF THE FEMALE PELVIS
Mapping of the uterine vasculature
ANATOMY of the arterial supply a. 2 uterine arteries b. 2 uterine-ovarian rings c. +/- round ligaments arteries Arcuate arteries Radial arteries Basal arteries Endometrial spiral arteries if the secretory phase
Normal (Pre-) Puberty findings
F, 13 y-o, no menstrual cycle: - Uterine corpus/cervix ratio >1 - Antral follicles development - Raised resistivity in the uterine arteries RI = 1.00
Proliferative (estrogenic) findings
F, 45y-o, the 12th day of the MC: - The endometrial “Triple-line sign” - Uterine arteries of central-type velocity with low resistance index