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Objective To compare the diagnostic value of two-dimensional ultrasound and three-dimensional color Doppler ultrasonography combined with alpha-fetoprotein (AFP) and creatine kinase (CK) in the diagnosis of scar uterus and placenta previa implantation.Methods 120 cases of pregnancy delivery documented in our hospital from February 2013 to January 2017 were selected as the research object.All cases were divided into implantation group and non implantation group accorded to the pathological diagnosis.The implantation group of 44 cases were diagnosed as placenta previa implantation and the non implantation group of 76 cases were diagnosed as non placenta previa implantation.Two-dimensional ultrasound and three-dimensional color Doppler ultrasound diagnosis characteristic and effect in the two groups were recorded.The AFP,CK expression in the two groups were also detected.Results AFP and CK expression were detected in the serum levels of all pregnant women.The AFP and CK expression in the implantation group were (152.80 ± 11.66) μg/L and (125.98 ± 16.67) IU/L,significantly higher than non implantation group [(80.65 ± 22.84) μg/L and (77.55 ± 23.32) IU/L,P ＜ 0.05].Ultrasonic diagnosis of placenta implantation in 39 cases,arid non placenta previa implantation81 cases;there were 38 cases of placenta accreta and 82 cases of non placenta previa implantation judged by AFP and CK expression;43 cases of placenta previa implantatio,and 77 cases of non placenta previa implantation judged by ultrasound combined with AFP and CK.So the combined diagnostic sensitivity were significantly higher than that of single diagnostic sensitivity (P ＜ 0.05).The receiver operating characteristic (ROC) curve shows that the area under the curve of ultrasound is =0.879,AFP and CK =0.835,and the ultrasound was better than AFP and CK.Conclusions The two-dimensional ultrasound and three-dimensional color Doppler ultrasonography combined with AFP and CK in the diagnosis of scar uterus and placenta previa implantation can improve the diagnostic effect,and they have very good application values.
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PURPOSE: To assess the feasibility and diagnostic accuracy of a sononohysterography-guided biopsy in an evaluation of focal endometrial lesions. MATERIALS AND METHODS: Sixty-five consecutive patients with focal endometrial lesions detected on baseline sonohysterography were enrolled prospectively. The biopsy was performed under real-time sonohysterography guidance, using a 3.1 mm Pipelle endometrial sampler as the primary biopsy device. The feasibility was evaluated from the technical success rates and the number of "diagnostic" specimen for the histological diagnosis. The diagnostic accuracy was assessed by comparing the biopsy results with the final pathological diagnosis obtained by the surgical procedure. RESULTS: Sonohysterography-guided biopsy was performed successfully in 59(90.8%) out of 65 patients. The reasons for failure in 6 patients were a failure to pass through the cervix (n=3); failure to target a focal lesion (n=2); and inadequate uterine distension (n=1). The biopsy specimen was "diagnostic" in 49 (83.1%) out of 50 patients, and "non-diagnostic" in 10 patients with insufficient tissue (n=6) and indeterminate cellular features for a histological diagnosis (n=4). The cytology results of the sonohysterographically-guided biopsy correlated well with the pathological diagnosis in 35 (92.1%) out of 38 patients who underwent subsequent surgical procedures. CONCLUSION: Sonohysterography-guided biopsy is technically feasible and can be an accurate method for diagnosing focal endometrial lesions. It could be considered to be a reliable office triage as an alternative to hysteroscopic biopsy in patients with focal endometrial abnormalities.
Subject(s)
BiopsyABSTRACT
Lipoleiomyoma is a rare benign neoplasm of the uterus. I present here a case of exophytic uterine lipoleiomyoma in a 77-year-old woman. Due to its exophytic nature, this fatty tumor mimicked ovarian teratoma on the imaging studies.
Subject(s)
Aged , Female , Humans , Leiomyoma , Lipoma , Teratoma , Uterine Neoplasms , UterusABSTRACT
Lipoleiomyoma is a rare benign neoplasm of the uterus. I present here a case of exophytic uterine lipoleiomyoma in a 77-year-old woman. Due to its exophytic nature, this fatty tumor mimicked ovarian teratoma on the imaging studies.
Subject(s)
Aged , Female , Humans , Leiomyoma , Lipoma , Teratoma , Uterine Neoplasms , UterusABSTRACT
PURPOSE: We attempted to evaluate the usefulness of Doppler sonography in the diagnosis of uterine vascular abnormality caused by previous D&E, and to report that transarterial embolization is an exceelent treatment modality. MATERIALS & METHODS: We analyzed gray-scale US, color/duplex Doppler US and angiographic findings inseven patients with radiologically proven uterine vascular abnormality. Two of the seven cases were pseudoaneurysms and five of the seven cases were AVMs. In one of the AVMs, two small pseudoaneurysms were combined. In all cases, transarterial embolizations using 3mm coil or/and gelfoam particles were performed. Follow-up US studies, including color Doppler US, were performed. RESULTS: On color/duplex Doppler sonography, two cases of pseudoaneurysm showed blood pools with turbulent arterial flow, and five cases of AVM showed asymmetrically increased vascularity, with variable high velocities composed of the pulsatie arterial flow, with ahigh diastoic component. On angiography, the former showed pseudoaneurysmal sacs, and the latter densely opacified vascular tangles. No more abnormal uterine bleeding was shown, following transarterial embolization in all cases. CONCLUSION: Color/duplex Doppler sonography was valuable in the diagnosis or treatment of abnormal uterine bleeding caused by uterine vascular abnormality such as acquired AVM or pseudoaneurysm.