ABSTRACT
AIM: To examine the usefulness of a gray scale histogram and computer assisted image analysis software in assessing physiologic states of the endometrium with ultrasonography. METHODS: Seventy patients at the Taipei Medical University-Wan Fang Hospital who matched eligibility criteria were categorized into one of three groups: (i) normal menstrual cycle, (ii) postmenopausal, and (iii) post incomplete abortion. Ultrasonography of the uterus was performed on each patient and the endometrium was analyzed with ImageJ image analysis software. RESULTS: A statistically significant difference in signal intensity scores of the gray level histogram, represented as m(j), was found between the groups. CONCLUSION: Ultrasonographic images analyzed using computer assisted image analysis software and gray level histogram are useful in assessing the physiological state of the endometrium.
Subject(s)
Endometrium/diagnostic imaging , Image Processing, Computer-Assisted/methods , Menstrual Cycle/physiology , Adult , Analysis of Variance , Endometrium/physiology , Female , Humans , UltrasonographyABSTRACT
OBJECTIVE: To examine the diagnostic feasibility of sonographic gray scale histograms to assess changes in the endometrium following abortion induced by mifepristone and misoprostol. DESIGN: Retrospective study. SETTING: Taipei Medical University-Wan Fang academic medical center. POPULATION OR SAMPLE: A total of 109 patients who matched eligibility criteria were divided into three groups: (a) complete abortion, (b) normal menstrual cycles, and (c) incomplete abortion. METHODS: Ultrasonographic examination of the uterus with fixed settings on each patient and sonographic gray scale histograms with image analysis software, using multivariate analysis by the partial least square model. MAIN OUTCOME MEASURES: Thickness, brightness, area and distribution of pixels of the endometrium and its contents. RESULTS: The groups could be discriminated (p < 0.01, Kruskal-Wallis test) using the analyzed gray scale histograms. The classification between complete and incomplete abortion reached 97% sensitivity and 100% specificity. CONCLUSIONS: Partial least square analysis of gray scale histograms of the endometrium in ultrasonographic images is useful in assessing endometrial changes.
Subject(s)
Abortion, Induced , Endometrium/diagnostic imaging , Image Processing, Computer-Assisted/methods , Abortifacient Agents, Nonsteroidal/therapeutic use , Abortifacient Agents, Steroidal/therapeutic use , Adult , Female , Humans , Least-Squares Analysis , Mifepristone/therapeutic use , Misoprostol/therapeutic use , Pregnancy , Retrospective Studies , Sensitivity and Specificity , UltrasonographySubject(s)
Fallopian Tubes/pathology , Fallopian Tubes/surgery , Pregnancy, Tubal/pathology , Pregnancy, Tubal/surgery , Adult , Depsipeptides , Fallopian Tubes/diagnostic imaging , Female , Fusarium , Humans , Laparoscopy , Pregnancy , Pregnancy, Tubal/diagnostic imaging , Recurrence , Ultrasonography, PrenatalABSTRACT
OBJECTIVE: Uterine rupture is one of the most serious obstetric complications, with an increased risk of maternal and perinatal morbidity, and even mortality. CASE REPORT: A multiparous woman came to our labor room at 41 weeks of gestation for induction of labor due to being post-term and having a nonreactive nonstress test. She had no history of abdominal or gynecologic surgery. Emergent cesarean section was performed due to prolonged decelerations shown on the fetal monitor. A 12 cm uterine laceration was identified after opening the abdominal cavity. Fortunately, her uterus was preserved and her postoperative condition was stable. CONCLUSION: To avoid maternal and fetal morbidity, or even mortality, obstetricians should be aware of the possible existence of uterine rupture in an unscarred uterus.
Subject(s)
Uterine Rupture/diagnosis , Acidosis/etiology , Brain Ischemia/etiology , Cesarean Section , Fatal Outcome , Female , Fetal Monitoring , Humans , Labor, Induced , Pregnancy , Pregnancy Outcome , Suture Techniques , Ultrasonography, Prenatal , Uterine Rupture/etiology , Uterus/surgeryABSTRACT
OBJECTIVE: The oral mifepristone/misoprostol combination (MMC) is safe for medical abortion in early pregnancy. The abortion status in MMC-treated pregnancies at Taipei Medical University-Wan Fang Medical Center was determined by ultrasonography, serum beta-human chorionic gonadotropin (beta-HCG), and histopathology. METHODS: All women at less than 49 days since the last menstruation who asked for legal abortion were evaluated by ultrasonography. They then received 600 mg of oral mifepristone followed 48 hours later by 600 microg of misoprostol. Women who had vaginal spotting or bleeding after 14 days were included in this study and underwent transvaginal ultrasonography, serum beta-HCG measurement and vacuum aspiration or therapeutic dilatation and curettage (D&C) on day 14. Specimens were identified by histopathology. Abortion status was determined from linear regression of serum beta-HCG and endometrial thickness. RESULTS: Of 35 women who underwent vacuum aspiration or therapeutic D&C, histopathology showed that 20 had decidual tissue and 15 had gestational tissue. Logistic regression showed that the distance measurement to the logistic regression line differed significantly between complete and incomplete abortion (p < 0.05). CONCLUSION: In this study, serum beta-HCG assays in addition to ultrasonographic evaluation helped to discriminate abortion status after oral MMC.
