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Sonohysterography: Do 3D Reconstructed Images Provide Additional Value?

Sujata V. Ghate1, Michele M. Crockett2, Brita K. Boyd3 and Erik K. Paulson1

1 Department of Radiology, Duke University Medical Center, Duke South Hospital, Box 3808, Durham, NC 27710.
2 Radiology Associates, Monroe, LA.
3 Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Duke South Hospital, Durham, NC.


Figure 1
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  		Fig. 1A —45-year-old woman who presented with abnormal uterine bleeding. Static 2D transverse saline infusion sonohysterographic image shows homogeneous echogenic mass along posterior fundus (arrows). Findings are consistent with polyp.

 

Figure 2
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  		Fig. 1B —45-year-old woman who presented with abnormal uterine bleeding. Transverse saline infusion sonohysterographic image of midbody of uterus shows second hypoechoic mass (arrows) along posterior wall with heterogeneous shadowing. Broad-based attachment and echogenicity suggest submucosal fibroid with greater than 50% protrusion into endometrial canal.

 

Figure 3
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  		Fig. 1C —45-year-old woman who presented with abnormal uterine bleeding. Three-dimensional coronal reformation shows both polyp (arrows) and fibroid (arrowheads) and their relation to each other. All readers were able to identify and characterize both lesions equally with 2D imaging alone and combined 2D and 3D imaging.

 

Figure 4
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  		Fig. 2A —35-year-old woman who presented with abnormal uterine bleeding. Static 2D sagittal saline infusion sonohysterographic image shows thin normal endometrium (arrows).

 

Figure 5
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  		Fig. 2B —35-year-old woman who presented with abnormal uterine bleeding. Three-dimensional coronal reformation shows normal endometrium and defines complete fundal contour (arrows). Readers were more confident is excluding fundal contour abnormality with 3D reformation.

 

Figure 6
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  		Fig. 3A —34-year-old woman who presented with multiple pregnancy losses and history of dilation and curettage. Static sagittal (A) and transverse (B) saline infusion sonohysterographic images suggest presence of septum (arrows).

 

Figure 7
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  		Fig. 3B —34-year-old woman who presented with multiple pregnancy losses and history of dilation and curettage. Static sagittal (A) and transverse (B) saline infusion sonohysterographic images suggest presence of septum (arrows).

 

Figure 8
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  		Fig. 3C —34-year-old woman who presented with multiple pregnancy losses and history of dilation and curettage. Three-dimensional coronal reformation defines and characterizes septum (arrows) better than do A and B. Irregularity suggests acquired rather than congenital septum.

 

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