ABSTRACT
PURPOSE: To assess the usefulness of four-dimensional (4D) ultrasonographic guidance in sonohysterographyguided biopsy of focal endometrial lesions. MATERIALS AND METHODS: Endometrial biopsies were performed prospectively under 4D ultrasound guidance in 24 consecutive patients with focal endometrial lesions detected on baseline sonohysterography. A single slice view in three orthogonal planes, a sagittal surface-rendered image, and multislice views in the sagittal plane were used for real-time guidance during the procedure. We evaluated feasibility based on the technical success rates and the number of "diagnostic" specimens obtained for histological diagnosis, and we correlated the biopsy results with the pathological diagnosis determined through the surgical procedure. RESULTS: Four-dimensional sonohysterography-guided biopsy was successfully performed in 21 (87.5%) of 24 patients without any significant complication. The biopsy specimens were diagnostic in 19 (90.5%) of 21 patients. Thirteen of 19 patients (68.4%) patients underwent surgery, and the diagnoses obtained using cytology correlated well with the pathology. CONCLUSION: Four-dimensional ultrasonography-guided biopsy is technically feasible and may be useful in the diagnosis of focal endometrial lesions.