ISSN: 1899-0967
Polish Journal of Radiology
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2018
vol. 83
 
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abstract:
Original paper

Diagnostic value of three-dimensional saline infusion sonohysterography in the evaluation of the uterus and uterine cavity lesions

Ahmed S.A. Sabry, Shimaa A. Fadl, Wojciech Szmigielski, Amal Alobaidely, Sanaa S.H. Ahmed, Hanan Sherif, Reda R.H. Yousef, Ahmed Mahfouz

© Pol J Radiol 2018; 83: e482-e490
Online publish date: 2018/11/30
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Purpose
The purpose of this review is to illustrate and discuss the seldom used technique of three-dimensional (3D) saline infusion sonohysterography (SIS) based on instillation of sterile saline through a catheter into the uterus under real-time vaginal transducer observation for assessment of the endometrial cavity.

Material and methods
The cases for this pictorial review were selected from the imaging material collected at the Ultrasound Unit, Clinical Imaging Department, Women’s Hospital of Hamad Medical Corporation during a seven-year period from 2011 to 2017. This was a retrospective collection of 216 consecutive cases that underwent two-dimensional (2D) and 3D SIS for evaluation of the uterine cavity, followed by verification of results with histopathology. An open-sided speculum is inserted into the vagina. An intrauterine catheter is then threaded into the endometrial cavity. After that, the speculum is removed carefully, and a vaginal transducer is inserted. Using a 60-ml syringe attached to the catheter, saline solution is instilled under direct real-time observation (2D SIS). Subsequently, reconstruction of the three-dimensional anatomy of the intrauterine cavity is performed.

Pictorial review
The review presents the most common indication for SIS, like abnormal bleeding in pre- and postmenopausal patients. SIS allows us to distinguish between focal lesions and global endometrial thickening. SIS should be supported as a second-line diagnostic procedure for abnormal uterine bleeding, when findings from transvaginal ultrasound are inconclusive.

Conclusions
The addition of 3D techniques to SIS procedure helps in the distinction between endometrial and myometrial lesions, also it facilitates delineation of uterine anatomy, resulting in more precise and accurate diagnosis.

keywords:

2 and 3 dimensions (2D and 3D), saline infusion sonography (SIS), ultrasound (US), polyps, submucous fibroids, synechiae

references:
Allison SJ, Horrow MM, Kim HY, Lev-Toaff AS. Saline-infused sonohysterography: tips for achieving greater success. Radiographics 2011; 31: 1991-2004.
Davis PC, O’Neill MJ, Yoder IC, et al. Sonohysterographic findings of endometrial and subendometrial conditions. Radiographics 2002; 22: 803-816.
Weinraub Z, Maymon R, Shulman A, et al. Three-dimensional saline contrast hysterosonography and surface rendering of uterine cavity pathology. Ultrasound Obstet Gynecol 1996; 8: 277-282.
Sconfienza LM, Lacelli F, Caldiera V, et al. Three-dimensional sonohysterography forexamination of the uterine cavity in women with abnormal uterine bleeding: Preliminary findings. J Ultrasound 2010; 13: 16-21.
Khan F, Jamaat S, Al-Jaroudi D. Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation. Ann Saudi Med 2011; 31: 387-392.
Salim R, Lee C, Davies A, et al. A comparative study of three-dimensional saline infusion sonohysterography and diagnostic hysteroscopy for the classification of submucous fibroids. Hum Reprod 2005; 20: 253-257.
Zafarani F, Ahmadi F. Evaluation of intrauterine structural pathology by three-dimensional sonohysterography using an extended imaging method. Int J Fertil Steril 2013; 7: 1-6.
Bittencourt CA, Dos Santos Simões R, Bernardo WM, et al. Accuracy of saline contrast sonohysterography in detection of endometrial polyps and submucosal leiomyomas in women of reproductive age with abnormal uterine bleeding: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2017; 50: 32-39.
Yung SS, Lai SF, Lam MT, et al. Randomized, controlled, double-blind trial of topical lidocaine gel and intrauterine lidocaine infusion for pain relief during saline contrast sonohysterography. Ultrasound Obstet Gynecol 2016; 47: 17-21.
Yang T, Pandya A, Marcal L, et al. Sonohysterography: Principles, technique and role in diagnosis of endometrial pathology. World J Radiol 2013; 5: 81-87.
Salim S, Won H, Nesbitt-Hawes E, et al. Diagnosis and management of endometrial polyps: a critical review of the literature. J Minim Invasive Gynecol 2011; 18: 569-581.
Cullinan JA, Fleischer AC, Kepple DM, Arnold AL. Sonohysterography: a technique for endometrial evaluation. Radiographics 1995; 15: 501-514; discussion 515-516.
Alatas C, Aksoy E, Akarsu C, et al. Evaluation of intrauterine abnormalities in infertile patients by sonohysterography. Hum Reprod 1997; 12: 487-490.
Verma SK, Lev-Toaff AS, Baltarowich OH, et al. Adenomyosis: sonohysterography with MRI correlation. Am J Roentgenol 2009; 192: 1112-1116.
Ludwin A, Pityński K, Ludwin I, et al. Two- and three-dimensional ultrasonography and sonohysterography versus hysteroscopy with laparoscopy in the differential diagnosis of septate, bicornuate, and arcuate uteri. J Minim Invasive Gynecol 2013; 20: 90-99.
Lindheim SR, Adsuar N, Kushner DM, et al. Sonohysterography: a valuable tool in evaluating the female pelvis. Obstet Gynecol Surv 2003; 58: 770-784.
de Kroon CD, Louwé LA, Trimbos JB, Jansen FW. The Clinical Value of 3-Dimensional Saline Infusion Sonography in Addition to 2-Dimensional Saline Infusion Sonography in Women with Abnormal Uterine Bleeding. J Ultrasound Med 2004; 23: 1433-1440.
Kupesic S. Clinical implications of sonographic detection of uterine anomalies for reproductive outcome. Ultrasound Obstet Gynecol 2001; 18: 387-400.
Ludwin A, Ludwin I, Kudla M, et al. Diagnostic accuracy of three-dimensional sonohysterography compared with office hysteroscopy and its interrater/intrarater agreement in uterine cavity assessment after hysteroscopic metroplasty. Fertil Steril 2014; 101: 1392-1399.
Malek-Mellouli M, Gharbi H, Reziga H. The value of sonohysterography in the diagnosis of tubal patency among infertile patients. Tunis Med 2013; 91: 387-390.
Van Schoubroeck D, Van den Bosch T, Meuleman C, et al. The use of a new gel foam for the evaluation of tubal patency. Gynecol Obstet Invest 2013; 75: 152-156.
Ryu JA, Kim B, Lee J, et al. Comparison of transvaginal ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding. Korean J Radiol 2004; 5: 39-46.
Erdem M, Bilgin U, Bozkurt N, Erdem A. Comparison of transvaginal ultrasonography and saline infusion sonohysterography in evaluating the endometrial cavity in pre- and postmenopausal women with abnormal uterine bleeding. Menopause 2007; 14: 846-852.
 
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