Three-dimensional sonographic evaluation of the common bile duct.

OBJECTIVE: To assess the accuracy of three-dimensional sonographic measurements of the common bile duct compared with standard two-dimensional anteroposterior measurement of the common duct. METHODS: Fifty-five consecutive patients referred for abdominal sonography underwent standard two-dimensional abdominal sonography followed by three-dimensional sonographic data acquisition of the right upper quadrant. A radiologist blinded to the results of the two-dimensional examination later measured the three-dimensional long axis anteroposterior common duct diameter and three-dimensional short axis anteroposterior and transverse common duct diameters. RESULTS: The mean average common duct diameter as measured by two-dimensional sonography (long axis anteroposterior) was 3.6 mm. The mean average common duct diameter as measured by long axis anteroposterior three-dimensional sonography was 4.1 mm. The mean average common duct diameter as measured by anteroposterior short axis three-dimensional sonography was 4.1 mm, and by transverse short axis three-dimensional sonography, it was 4.4 mm. The two-dimensional common duct measurement correlated with the long axis anteroposterior three-dimensional measurement (P < .001), the short axis anteroposterior three-dimensional measurement (P < .001), and the short axis transverse three-dimensional measurement (P < .005) by the Spearman rank order correlation coefficient test. CONCLUSIONS: Three-dimensional sonographic measurements of the common bile duct correlate highly with two-dimensional measurements, validating the use of three-dimensional sonography as a reliable method for evaluation of common bile duct size.

Three-dimensional ultrasonography: an objective outcome tool to assess collagen distribution in women with stress urinary incontinence.

OBJECTIVES: To examine the distribution of periurethral collagen by three-dimensional ultrasonography (3D US) and to incorporate this technology into a practical treatment decision tree for women with stress urinary incontinence desiring collagen injection. METHODS: Forty-six women who received periurethral collagen injection were assessed with 3D US to document the position and volume of collagen around the urethra. Patients with a good clinical response were observed with serial 3D US scans. Women with no persistent improvement who showed a low volume or asymmetric distribution of collagen were offered repeat injections. When the patient had no improvement despite symmetric or circumferential distribution of collagen with good volume retention, another anti-incontinence treatment was recommended. Group 1 was composed of women who had a good clinical outcome and group 2 of those who did not. A statistical comparison between the two outcome groups was done to determine whether any particular distribution pattern was associated with an increased likelihood of clinical success. RESULTS: Of the 46 patients, 21 (46%) were satisfied with their continence after their last periurethral collagen injection, with a median follow-up of 14.0 months (range 2 months to 4.25 years). A significantly greater proportion of patients in group 1 had circumferentially distributed collagen on 3D US compared with those in group 2 (62% versus 20%, P = 0.006). CONCLUSIONS: Circumferential distribution of collagen around the urethra is associated with a higher likelihood of clinical success. The assessment of periurethral collagen by 3D US provides an affordable, noninvasive, objective outcome measure that may aid in treatment planning.