Two- and three-dimensional sonography of anomalies of orofacial area in the first trimester of gestation

As part of the population-based prenatal screening of 900 pregnant women, who underwent 1st trimester screening at the RPMC “Mother and Child” in 2018–2019, an ultrasound scan of the fetal palate was performed to evaluate the effectiveness of new ultrasound markers in detecting orofacial clefts (OFC). Fetal palatal defects were screened at a 2D assessment of bone markers of the palate – the image of the palatal line in the sagittal section, the retronasal triangle in the coronary section, the alveolar arch of the upper jaw in the axial section. If a palate abnormality was detected or suspected in the 2D study, the fetal palate was evaluated using the 3D mode. In 50 pregnant women of the control group, 3D sonography of the fetal palate was performed in the norm. In total, during the gestation period of 10+5–12+5 weeks, 10 cases of OFC were detected, of which 1 case was a median lip/palate cleft (LPC), 6 — bilateral LPC, 1 — left-sided LPC, 1 — unspecified LPC, 1 — PC. Visualization of 2D ultrasound markers was possible in 9 cases of palate anomalies, 3D assessment worked out in all 10 cases. In all identified OFC cases, cytogenetic and/or pathomorphological studies were performed.

Diagnostic Accuracy of 3D-transvaginal Ultrasound Compared to Hysteroscopy in Detecting Uterine Abnormalities Before ICSI

Introduction Various forms of female infertility were associated with congenital uterine anomalies and acquired uterine disease. In fact, the myometrium can only be indirectly imaged by X-ray hysterosalpingography but is directly seen on Ultrasonography. More recently, further advances in ultrasonography have led to three-dimensional multiplanar or volume imaging (three-dimensional ultrasonography [3DUS]) in which sonographic images are obtained from a volume of ultrasonographic data (rather than from a slice of data) the application of 3DUS to gynecologic imaging has suggested a role for transvaginal 3DUS in the assessment of uterine anomalies and endometrial lesions. Aim To evaluate the diagnostic accuracy and sensitivity of Hysteroscopy vs TV3D in the evaluation of the uterine abnormalities in infertile women before ICSI. Methodology This is a study including 60 patients were selected from the outpatient gynecological clinic, private center at Sohag government (Ibn Sina Center) in collaboration with (Ain Shams University Hospital in IVF unit) from12/2017 -8/2018. All cases files are computerized and saved in Ibn Sina Center. Results The overall result of accuracy of different modalities was 98.3% for 3D sonography and the accuracy of different modalities in detection of endometrial polyp was 93.3% for 3D sonography and 100% for hysteroscopy. The accuracy of different modalities in detection of septate uterus was 100% for 3D sonography and hysteroscopy. The accuracy of different modalities in detection of intrauterine adhesions was 100% for 100% for 3D and hysteroscopy. Conclusion Hysteroscopy is the gold standard diagnostic & therapeutic tool for uterine anomalies (bicornuate, septate, arcuate, polyp), However 3D ultrasonography is diagnostic tool only but superior to hysteroscopy in certain lesions e.g. (subserous and intramural fibroid). Recommendation we recommend 3D to become soon as the diagnostic procedure of choice in assessment of suspected uterine lesions. Furthermore, we recommend that 3D US, if available, to be performed routinely for all cases of uterine cavity anomalies and prior to corrective uterine surgery.

Diagnostic Role of Ultrasonography in Obstetrics and Gynaecology

Ultrasonography (USG) is widely used in both gynaecology and obstetrics. USG has become an indispensable diagnostic tool. Specially in our developing country. Advanced US technologies, such as 3D sonography, provide powerful and highly accurate diagnostic tools. The clinical applications and uses of ultrasound include confirmation of pregnancy including multiple gestation, estimation of gestational age, localization of placenta and monitoring of foetal wellbeing. The others are evaluation of caesarean section scar integrity and post partum haemorrhage. Ultrasound is also useful in prenatal diagnosis of foetal anomaly. The clinical uses of ultrasound in gynaecology include diagnosis of uterine abnormality, ovarian tumour. Ovarian follicles follow up in infertility, diagnosis of ectopic pregnancy, evaluation of abortion case. Detection of pelvic mass & polycystic ovarian disease is also important. Ultrasound guided FNAC is also an important diagnostic tool.TAJ 2011; 24(2): 152-155

Feasibility and Quality Determinants of 3D Sonography in Children With Hydronephrosis

The objective was to determine the image quality of 3D diagnostic medical sonography (DMS) in children with hydronephrosis. 3D DMS was assessed based on 24 pediatric patients. Image quality was evaluated by two radiologists and a sonographer in terms of rib shadowing, cut-off parenchymal edges, motion artifact, and overall quality. The interreader reliability and relation between image quality and other variables were calculated. The results were based on images of 32 hydronephrotic kidneys. The average quality scoring of the images was quite high. Rib shadowing, cut-off edges, and motion artifact were present in the majority of the cases. The interreader reliability for overall quality, rib shadowing, cut-off, and motion was quite high. There was a correlation between the Society for Fetal and Neonatal Urology’s hydronephrosis grade and higher cut-off edges. Larger kidneys were more likely to show cut-off, motion, and lower quality scores. In this cohort of infants and toddlers with hydronephrotic kidneys, 3D DMS demonstrated good image quality; however, artifacts were attributed to kidney size and severity of hydronephrosis.

Interobserver Agreement in the Study of 2D and 3D Sonographic Criteria for Adenomyosis

Objective To study the degree of interobserver agreement for already known two-dimensional (2D) and three-dimensional (3D) sonography criteria of adenomyosis. Methods Fifty cases (25 adenomyosis cases, 25 non-adenomyosis cases) were studied by four expert observers and a less-experienced researcher. Each sonographic adenomyosis criterion was separately studied. Interobserver agreement was analysed by the kappa index with 95% confidence interval (CI). Results The degree of agreement about diagnosing adenomyosis was high or very high in all pair-wise comparisons (kappa values of 0.58–0–92). The agreement on identifying intra-myometrial cysts (kappa values of 0.46–0.79) and evaluating the junctional zone (JZ) by 3D-transvaginal ultrasound (3D-TVS) (kappa index of 0.46–0.88) was good. The agreements reached when evaluating the other criteria varied, but good agreement was generally reached. Conclusions Both the 2D-TVS and 3D-TVS criteria employed in diagnosing adenomyosis were reproducible parameters in adenomyosis diagnostics. The results were reproducible, even by a less experienced observer.