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1.
Diagnostics (Basel) ; 13(4)2023 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-36832299

RESUMO

(1) Background: This study aims to compare the ground truth (pathology results) against the BI-RADS classification of images acquired while performing breast ultrasound diagnostic examinations that led to a biopsy and against the result of processing the same images through the AI algorithm KOIOS DS TM (KOIOS). (2) Methods: All results of biopsies performed with ultrasound guidance during 2019 were recovered from the pathology department. Readers selected the image which better represented the BI-RADS classification, confirmed correlation to the biopsied image, and submitted it to the KOIOS AI software. The results of the BI-RADS classification of the diagnostic study performed at our institution were set against the KOIOS classification and both were compared to the pathology reports. (3) Results: 403 cases were included in this study. Pathology rendered 197 malignant and 206 benign reports. Four biopsies on BI-RADS 0 and two images are included. Of fifty BI-RADS 3 cases biopsied, only seven rendered cancers. All but one had a positive or suspicious cytology; all were classified as suspicious by KOIOS. Using KOIOS, 17 B3 biopsies could have been avoided. Of 347 BI-RADS 4, 5, and 6 cases, 190 were malignant (54.7%). Because only KOIOS suspicious and probably malignant categories should be biopsied, 312 biopsies would have resulted in 187 malignant lesions (60%), but 10 cancers would have been missed. (4) Conclusions: KOIOS had a higher ratio of positive biopsies in this selected case study vis-à-vis the BI-RADS 4, 5 and 6 categories. A large number of biopsies in the BI-RADS 3 category could have been avoided.

2.
Diagnostics (Basel) ; 12(12)2022 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-36552967

RESUMO

In recent years, due to the development of standardized diagnostic protocols associated with an improvement in the associated technology, the diagnosis of pelvic endometriosis using imaging is becoming a reality. In particular, transvaginal ultrasound and magnetic resonance are today the two imaging techniques that can accurately identify the majority of the phenotypes of endometriosis. This review focuses not only on these most common imaging modalities but also on some additional radiological techniques that were proposed for rectosigmoid colon endometriosis, such as double-contrast barium enema, rectal endoscopic ultrasonography, multidetector computed tomography enema, computed tomography colonography and positron emission tomography-computed tomography with 16α-[18F]fluoro-17ß-estradiol.

3.
Eur J Obstet Gynecol Reprod Biol ; 261: 29-33, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33873085

RESUMO

OBJECTIVES: The aim of this study was to compare the accuracy of seven classical Machine Learning (ML) models trained with ultrasound (US) soft markers to raise suspicion of endometriotic bowel involvement. MATERIALS AND METHODS: Input data to the models was retrieved from a database of a previously published study on bowel endometriosis performed on 333 patients. The following models have been tested: k-nearest neighbors algorithm (k-NN), Naive Bayes, Neural Networks (NNET-neuralnet), Support Vector Machine (SVM), Decision Tree, Random Forest, and Logistic Regression. The data driven strategy has been to split randomly the complete dataset in two different datasets. The training dataset and the test dataset with a 67 % and 33 % of the original cases respectively. All models were trained on the training dataset and the predictions have been evaluated using the test dataset. The best model was chosen based on the accuracy demonstrated on the test dataset. The information used in all the models were: age; presence of US signs of uterine adenomyosis; presence of an endometrioma; adhesions of the ovary to the uterus; presence of "kissing ovaries"; absence of sliding sign. All models have been trained using CARET package in R with ten repeated 10-fold cross-validation. Accuracy, Sensitivity, Specificity, positive (PPV) and negative (NPV) predictive value were calculated using a 50 % threshold. Presence of intestinal involvement was defined in all cases in the test dataset with an estimated probability greater than 0.5. RESULTS: In our previous study from where the inputs were retrieved, 106 women had a final expert US diagnosis of rectosigmoid endometriosis. In term of diagnostic accuracy the best model was the Neural Net (Accuracy, 0.73; sensitivity, 0.72; specificity 0.73; PPV 0.52; and NPV 0.86) but without significant difference with the others. CONCLUSIONS: The accuracy of ultrasound soft markers in raising suspicion of rectosigmoid endometriosis using Artificial Intelligence (AI) models showed similar results to the logistic model.


Assuntos
Endometriose , Inteligência Artificial , Teorema de Bayes , Endometriose/diagnóstico por imagem , Feminino , Humanos , Sensibilidade e Especificidade , Ultrassonografia
4.
Diagnostics (Basel) ; 10(6)2020 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-32471042

RESUMO

In the present pictorial we show the ultrasonographic appearances of endometriosis in atypical sites. Scar endometriosis may present as a hypoechoic solid nodule with hyperechoic spots while umbilical endometriosis may appear as solid or partially cystic areas with ill-defined margins. In the case of endometriosis of the rectus muscle, ultrasonography usually demonstrates a heterogeneous hypoechogenic formation with indistinct edges. Inguinal endometriosis is quite variable in its ultrasonographic presentation showing a completely solid mass or a mixed solid and cystic mass. The typical ultrasonographic finding associated with perineal endometriosis is the presence of a solid lesion near to the episiotomy scar. Under ultrasonography, appendiceal endometriosis is characterized by a solid lesion in the wall of the small bowel, usually well defined. Superficial hepatic endometriosis is characterized by a small hypoechoic lesion interrupting the hepatic capsula, usually hyperechoic. Ultrasound endometriosis of the pancreas is characterized by a small hypoechoic lesion while endometriosis of the kidney is characterized by a hyperechoic small nodule. Diaphragmatic endometriosis showed typically small hypoechoic lesions. Only peripheral nerves can be investigated using ultrasound, with a typical solid appearance. In conclusion, ultrasonography seems to have a fundamental role in the majority of endometriosis cases in "atypical" sites, in all the cases where "typical" clinical findings are present.

5.
Gynecol Endocrinol ; 35(7): 612-617, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30727778

RESUMO

To determine if patients with a DC respond similarly to ovarian stimulation when compared to patients without a DC. Infertility patients with a DC that underwent IVF between January 2009 and December 2016 were included. A cystic mass with mixed echogenicity, internal echoes similar to thick bands, fatty-fluid level, or an echogenic tubercle with acoustic shadow (Rokitansky nodule) within two years of the cycle characterized the diagnosis. The z-score compared the standard deviations (SDs) in patients with/without a DC and were compared to a nomogram (expected oocytes minus oocytes obtained divided by the SD), adjusted for age and number of oocytes retrieved, built utilizing cycles from noninfertile female patients. Thirty-nine patients with DC and 7839 patients without DC were identified. The mean number of oocytes (8.6 ± 5.8 vs. 8.5 ± 7.7, p = .43) and MIIs (6.7 ± 4.7 vs. 7.0 ± 6.7, p = .74) retrieved were similar. When cycles with and without a DC were compared to the nomogram (z-score of 0), cycles with a DC presented a z-score for ovarian response of 0.1921 SDs from the mean, and patients without DC presented a z-score of -0.2065 SDs from the mean (similar and less than -1.0). After building a population 'normal' response as a template, patients with and without a DC responded similar to COS.


Assuntos
Cisto Dermoide/diagnóstico por imagem , Fertilização in vitro , Neoplasias Ovarianas/diagnóstico por imagem , Indução da Ovulação , Adulto , Feminino , Humanos , Recuperação de Oócitos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Ultrassonografia
6.
Gynecol Oncol ; 150(3): 438-445, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30029961

RESUMO

OBJECTIVES: The aim is to estimate agreement between two-dimensional transvaginal ultrasound (2D-TVS) and three-dimensional volume contrast imaging (3D-VCI) in diagnosing deep myometrial invasion (MI) and cervical stromal involvement (CSI) of endometrial cancer and to compare the two methods regarding inter-rater reliability and diagnostic accuracy. METHODS: Fifteen ultrasound experts assessed off-line de-identified 3D-VCI volumes and 2D-TVU video clips from 58 patients with biopsy-confirmed endometrial cancer regarding the presence of deep (≥50%) MI and CSI. Video clips and 3D volumes were assessed independently. Interrater reliability was measured using kappa statistics. Histological diagnosis after hysterectomy served as gold standard. Accuracy measurements were correlated to rater experience using Spearman's rank correlation coefficient (ρ). RESULTS: Agreement between 2D-TVU and 3D-VCI for diagnosing MI was median 76% (range 64-93%) and for CSI median 88% (range 79-97%). Interrater reliability was better for 2D-TVU than for 3D-VCI (Fleiss' kappa 0.41 vs. 0.31 for MI and 0.55 vs. 0.45 for CSI). Median accuracy for diagnosing deep MI was 76% (range 59-84%) with 2D-TVU and 69% (range 52-83%) for 3D-VCI; the corresponding figures for CSI were 88% (range 81-93%) and 86% (range 72-95%). Accuracy was significantly correlated to how many cases the raters assessed annually. CONCLUSIONS: Off-line assessment of MI and CSI in women with endometrial cancer using 3D-VCI has lower interrater reliability and lower accuracy than 2D-TVU video clip assessment. Since accuracy was correlated to the number of cases assessed annually it is advised to centralize these examinations to high-volume centres.


Assuntos
Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/patologia , Imageamento Tridimensional , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Miométrio/diagnóstico por imagem , Miométrio/patologia , Invasividade Neoplásica , Estadiamento de Neoplasias/métodos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Estudos Retrospectivos
7.
Obstet Gynecol ; 130(6): 1244-1250, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29112653

RESUMO

OBJECTIVE: To assess the natural history of ultrasonographically diagnosed benign ovarian teratomas in asymptomatic women. METHODS: We conducted a retrospective observational cohort study of 408 women (mean age 36.6 years, range 14-81 years) diagnosed as having an ovarian teratoma by transvaginal ultrasonography (except eight who only had a transabdominal study done) between January 2003 and December 2013 at a single tertiary care institution. Six hundred thirteen women were diagnosed with ovarian teratoma of whom 205 were promptly treated surgically, leaving 408 patients followed conservatively with follow-up scans at 3 and 6 months from diagnosis and then yearly. The ultrasonographic diagnosis of a benign ovarian teratoma required at least one of the following features: a cystic mass with mixed echogenicity, thick band-like echoes, a fat-fluid level, or echogenic tubercle with posterior shadowing. Clinical, ultrasonographic, and histologic data (in case of surgery) were retrieved for analysis. RESULTS: During follow-up, 130 of 408 (31.8%) women underwent surgery. The main reason for surgery was the physician's recommendation according to our protocol (n=115). One patient had adnexal torsion. Most surgeries (112/130 [86.2%]) were performed within the first 5 years after diagnosis. The remainder (278/408) is still being followed (median time 45.6 months, range 6-147 months). The vast majority of these lesions had no change and women remain asymptomatic. Histologic diagnosis of tumors removed surgically revealed a benign ovarian teratoma in 103 of 130 (79.2%) of the women. There were two borderline tumors, four endometriomas, three fibromas, seven serous cysts, two mucinous cysts, two stroma ovarii, seven other benign, and no case of malignant tumor. CONCLUSION: Our results demonstrate that expectant management might be a reasonable option for managing asymptomatic women who receive a ultrasonographic diagnosis of a benign ovarian teratoma. The risk of undergoing surgery for this lesion decreases significantly after 5 years to follow-up. With careful observation, the risk of missing a diagnosis of malignancy is low.


Assuntos
Cistos Ovarianos , Neoplasias Ovarianas , Ovário , Teratoma , Ultrassonografia , Adulto , Fatores Etários , Gerenciamento Clínico , Feminino , Humanos , Efeitos Adversos de Longa Duração/diagnóstico , Efeitos Adversos de Longa Duração/epidemiologia , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/patologia , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/patologia , Ovariectomia/métodos , Ovariectomia/estatística & dados numéricos , Ovário/diagnóstico por imagem , Ovário/patologia , Estudos Retrospectivos , Espanha , Teratoma/diagnóstico , Teratoma/patologia , Carga Tumoral , Ultrassonografia/métodos , Ultrassonografia/estatística & dados numéricos
8.
J Ultrasound Med ; 36(7): 1347-1354, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28449311

RESUMO

OBJECTIVES: To estimate intraobserver and interobserver reproducibility for assigning an International Endometrial Tumor Analysis (IETA) group color score for endometrial vascularization on color Doppler imaging. METHODS: Sixty-eight endometrial 3-dimensional volumes from endometrial color Doppler assessments of women with different endometrial disorders were evaluated by 8 different examiners (4 skilled examiners and 4 obstetric and gynecologic trainees). One skilled examiner who did not participate in the assessments selected the 68 volumes from a database to select a balanced number of each IETA score. Each examiner evaluated the 68 endometrial volumes to assign the IETA color score (1, absence of vascularization; 2, low vascularization; 3, moderate vascularization; or 4, abundant vascularization) using tomographic ultrasound imaging. The analysis was repeated 4 weeks later, and interobserver and intraobserver reproducibility was analyzed by calculating the weighted κ index. The second of the measurements made by each observer was used to estimate interobserver reproducibility. RESULTS: The intraobserver reproducibility was very good for all examiners, with a weighted κ index ranging from 0.84 to 0.91. The interobserver reproducibility was good or very good for all estimated comparisons, with a weighted κ index ranging from 0.77 to 0.96, regardless of experience level. CONCLUSIONS: The reproducibility of assigning the IETA color score for assessing endometrial vascularization using 3-dimensional volumes is good or very good regardless of the experience of the examiner.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Endométrio/diagnóstico por imagem , Endométrio/fisiologia , Interpretação de Imagem Assistida por Computador/normas , Imageamento Tridimensional/normas , Ultrassonografia Doppler em Cores/normas , Adulto , Feminino , Humanos , Internacionalidade , Variações Dependentes do Observador , Tamanho do Órgão , Guias de Prática Clínica como Assunto , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
9.
Menopause ; 24(6): 613-616, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28118296

RESUMO

OBJECTIVE: To assess the natural history of benign appearing purely solid ovarian lesions in asymptomatic postmenopausal women. METHODS: Retrospective observational cohort study comprising 99 women (mean age, 58.2 years, ranging from 50 to 77 years) diagnosed as having a purely solid ovarian lesion at transvaginal ultrasound between April 2001 and October 2015. Inclusion criteria were as follows: asymptomatic postmenopausal women with a well-defined purely solid ovarian lesion with International Ovarian Tumor Analysis color score 1 or 2, without ascites and/or signs of carcinomatosis. Clinical, sonographic, biochemical (CA-125), and histologic data (in case of surgery) were retrieved for analysis. Patients who were managed conservatively were assessed by transvaginal sonography every 6 months for a minimum of a year. In case of bilateral lesions we used the largest one for analysis. RESULTS: Five women (5.1%) had bilateral lesions. Mean size of the lesion was 2.9 cm (range, 1.0-7.8 cm). Most lesions were homogeneous (96.0%). Acoustic shadowing was present in 59.6% of cases. International Ovarian Tumor Analysis color score was 1 in 77.8% and 2 in 22.2% of the cases, respectively. Median CA-125 was 10.8 IU/mL (range, 3.0-403.0 IU/mL). Forty-two women underwent surgery after diagnosis (histologic diagnoses were as follows: fibroma (n = 26), fibrothecoma (n = 5), dermoid (n = 3), Brenner tumor (n = 3), endometrioma (n = 2), thecoma (n = 1), primary invasive cancer (n = 2). One case of invasive cancer CA-125 was 403.0 IU/mL and in the other case CA-125 was 6.0 IU/mL. They both were stage 1. Fifty-seven women were managed with serial follow-up. With a median follow-up time of 36 months (range, 12-142 months) all these lesions had no change and women remain asymptomatic. Considering all 99 cases the risk of malignancy is 2% (95% CI, 0.1-7.5). CONCLUSIONS: The risk of malignancy of benign appearing purely solid adnexal masses in asymptomatic postmenopausal women is low. Conservative management of these lesions might be an option.


Assuntos
Doenças Ovarianas/diagnóstico , Neoplasias Ovarianas/diagnóstico , Pós-Menopausa , Ultrassonografia , Idoso , Antígeno Ca-125/sangue , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Ovarianas/patologia , Doenças Ovarianas/cirurgia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Estudos Retrospectivos , Fatores de Risco
10.
J Reprod Med ; 62(3-4): 133-7, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-30230304

RESUMO

Objective: To compare the uterine transverse diameter (UTD) in women with normal uteri and women with uterine canalization defects as well as to assess its performance for ruling out such defects. Study Design: Retrospective analysis of prospectively collected data in a series of selected women with primary or secondary infertility. Measurement of UTD and 3D volume acquisition for subsequent off-line analysis was performed in order to identify possible canalization defects. UTD of the normal uterus, measured by 2D ultrasound, was compared to that of arcuate, subseptate, and septate uteri. ROC curve was plotted to determine the best UTD cutoff for differentiating normal from abnormal uteri. Results: A total of 421 women were ultimately evaluated. UTD was significantly larger in women with arcuate (53.3 mm, SD 6.3, p<0.05), subseptate (55.0 mm, SD 6.7, p<0.05), and septate (56.0 mm, SD 4.8, p<0.05) uterus as compared with the normal uterus (45.9 mm, SD 7.1). ROC curve showed that the best UTD cutoff for ruling out the presence of a uterine canalization defect was 45 mm (AUC 0.809, 95% CI 0.768­0.849). Conclusion: Measurement of UTD may be a simple and practical method for ruling out a uterine canalization defect in infertile women.


Assuntos
Colo do Útero/anormalidades , Colo do Útero/cirurgia , Infertilidade Feminina/diagnóstico por imagem , Anormalidades Urogenitais/diagnóstico por imagem , Útero/anormalidades , Adulto , Feminino , Humanos , Histeroscopia/métodos , Imageamento Tridimensional , Infertilidade Feminina/cirurgia , Gravidez , Estudos Retrospectivos , Ultrassonografia/métodos , Anormalidades Urogenitais/cirurgia , Útero/diagnóstico por imagem , Útero/cirurgia , Adulto Jovem
11.
J Clin Ultrasound ; 45(2): 112-115, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27612443

RESUMO

Rudimentary horn pregnancy occurs in 1 in 76,000-150,000 pregnancies and causes uterine rupture in about 80% of cases. The use of three-dimensional transvaginal ultrasound seems to be useful for its early detection. We present a case of an 8-week pregnancy in a rudimentary horn, managed by laparoscopic excision. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:112-115, 2017.


Assuntos
Laparoscopia , Gravidez Cornual/diagnóstico por imagem , Gravidez Cornual/cirurgia , Ultrassonografia Pré-Natal/métodos , Útero/anormalidades , Adulto , Feminino , Humanos , Imageamento Tridimensional , Gravidez , Útero/diagnóstico por imagem
12.
J Clin Ultrasound ; 39(6): 316-21, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21500198

RESUMO

PURPOSE: The purpose of this study was to investigate the intraobserver and interobserver agreements in the diagnosis of malignant versus benign adnexal masses using two-dimensional ultrasonography (2D US) and three-dimensional ultrasonography (3D US). METHODS: Two experienced sonographers performed a retrospective review of digitally stored 2D images and 3D data from a sample of 41 consecutive patients with a diagnosis of adnexal mass. Each observer independently, and blinded to each other, evaluated the 2D static images of each adnexal mass and then the 3D volumes 1 week later. The observers were required to classify the adnexal lesion as benign or malignant according to pattern recognition analysis. Intraobserver and interobserver agreement were assessed by calculating the kappa index (κ). RESULTS: Intraobserver agreement between 2D US and 3D US for the observer A was 1.00 and for the observer B was 0.69. Interobserver agreement was 0.69 for 2D US and 1.00 for 3D US (p > 0.05) CONCLUSIONS: Although 3D US in the diagnosis of adnexal masses appeared more reproducible than 2D US, the difference was not statistically significant.


Assuntos
Doenças dos Anexos/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Doenças dos Anexos/patologia , Adulto , Competência Clínica , Diagnóstico Diferencial , Feminino , Humanos , Imageamento Tridimensional , Variações Dependentes do Observador , Neoplasias Ovarianas/patologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Ultrassonografia Doppler
13.
J Womens Health (Larchmt) ; 20(2): 273-7, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21265646

RESUMO

OBJECTIVE: To evaluate the reproducibility and accuracy of color Doppler flow location in indeterminate masses after a gray-scale sonography in the diagnosis of ovarian malignancy. METHODS: Digitally stored color Doppler sonographic images from a random sample of 130 women with an indeterminate adnexal mass submitted to surgery were evaluated by six different examiners with different degrees of experience. A mass was graded malignant if flow was shown within the excrescences or solid areas. Intraobserver agreement and interobserver agreement according to the level of experience were assessed by calculating the kappa index. RESULTS: Intraobserver agreement was good for all examiners with different degrees of experience (kappa 0.72-0.89). Interobserver agreement was good to moderate for all operators (kappa 0.48-0.71) irrespective of degree of experience. The accuracy was comparable among different operators. CONCLUSIONS: Our results indicate that color Doppler imaging for detection of adnexal malignancy seems to be a reproducible method even in moderately experienced examiners.


Assuntos
Anexos Uterinos/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Variações Dependentes do Observador , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
14.
Fertil Steril ; 94(7): 2761-5, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20356583

RESUMO

OBJECTIVE: To evaluate the diagnostic accuracy of introital three-dimensional (3D) transvaginal sonography for preoperative detection of rectovaginal septal endometriosis. DESIGN: Ultrasonographic results were compared with surgical and histologic findings. SETTING: University Department of Obstetrics and Gynecology. PATIENT(S): This prospective study included 39 women with suspected rectovaginal endometriosis. INTERVENTION(S): All patients underwent 3D transvaginal sonography for the evaluation of the rectovaginal septum, before undergoing laparoscopic radical resection of endometriosis. Rectovaginal endometriosis was defined as hypoechoic areas, nodules, or anatomic distortion of this specific location. MAIN OUTCOME MEASURE(S): Sensitivity, specificity, and likelihood ratios (positive or negative) were calculated with 95% confidence intervals (CIs). RESULT(S): Surgery associated with histopathologic evaluation revealed deep endometriosis in the rectovaginal septum in 19 patients. The specificity, sensitivity, positive likelihood ratio, and negative likelihood ratio were 94.7% (95% CI, 78.6%-99.7%), 89.5% (95% CI, 73.3%-94.5%), 17.2 (95% CI, 2.51-115), and 0.11 (95% CI, 0.03-0.41), respectively. CONCLUSION(S): Introital 3D ultrasonography seems to be an effective method for the diagnosis of endometriosis of the rectovaginal septum and should be included in the preoperative evaluation of patients with clinical suspicion of deep endometriosis.


Assuntos
Endometriose/diagnóstico por imagem , Endossonografia/métodos , Imageamento Tridimensional , Doenças Retais/diagnóstico por imagem , Doenças Vaginais/diagnóstico por imagem , Adulto , Endometriose/cirurgia , Feminino , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Imageamento Tridimensional/métodos , Laparoscopia/métodos , Valor Preditivo dos Testes , Doenças Retais/cirurgia , Reto/diagnóstico por imagem , Sensibilidade e Especificidade , Vagina/diagnóstico por imagem , Doenças Vaginais/cirurgia
15.
Gynecol Endocrinol ; 24(11): 631-6, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19031220

RESUMO

OBJECTIVE: To assess whether there are differences in ovarian echogenicity and vascularization as assessed by three-dimensional power Doppler angiography (3D-PDA) between women with polycystic ovaries (PCO) and women with normal ovaries (NO). METHODS: Eighty-three women were classified into two groups according to the 2003 Rotterdam consensus criteria. The NO group comprised women (n = 45) with regular menstrual cycles and proven fertility, whereas the PCO group comprised women (n = 38) with oligo-anovulation, clinical and/or biochemical features of hyperandrogenism, and polycystic ovary morphology at two-dimensional ultrasound. All women were evaluated by means of 3D-PDA. The parameters studied in both groups were follicle number per ovary (FNPO), ovarian volume (OV), mean gray value (MG) and three vascular indices: vascularization index (VI), flow index (FI) and vascularization flow index (VFI). RESULTS: The PCO group showed a higher mean OV as well as FNPO. No differences in MG, VI, FI and VFI were found between the groups. CONCLUSIONS: 3D-PDA indices are not useful for discriminating between normal and polycystic ovaries.


Assuntos
Ovário/irrigação sanguínea , Síndrome do Ovário Policístico/diagnóstico por imagem , Adulto , Angiografia , Estudos de Casos e Controles , Feminino , Humanos , Tamanho do Órgão , Ovário/diagnóstico por imagem , Ovário/patologia , Síndrome do Ovário Policístico/patologia , Ultrassonografia Doppler em Cores , Adulto Jovem
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