Evaluation Of Transvaginal Three-dimensional Ultrasonography OmniView Technology In The Diagnosis Of Uterine Cavity Disease

Objective To assess the value of transvaginal three-dimensional ultrasound free anatomical imaging technology in the diagnosis of uterine cavity disease and retrospectively analyze endometrial cavity sonographic features in the coronal plane in patients with intrauterine adhesion.Methods 303 patients with uterine cavity disease diagnosed by diagnostic curettage and hysteroscopy were analyzed retrospectively by two-dimensional and three-dimensional transvaginal ultrasound(2D-TVS and 3D-TVS)at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2016 to May 2018.Each 3D ultrasonography dataset was analyzed by the OmniView technique to obtain the coronal plane image of the uterine cavity.The results of surgical pathology and hysteroscopy were used as a gold standard.To compare the evaluation index of 2D-TVS and OmniView technology in the diagnosis of uterine cavity disease and the sensitivity of the two methods in the classification of submucosal uterine fibroids and intrauterine adhesion,meanwhile summarize the morphologic characteristics of intrauterine adhesion.Results 1.303 cases of patients with a final pathological results:85 cases of endometrial hyperplasia,72 cases of endometrial polyps,18 cases of intrauterine fetal residues,8 cases of endometrial carcinoma,63 cases of submucosal uterine fibroids and 57 cases of IUA.The classification results of 63 cases of submucosal uterine fibroids by hysteroscopy:21 cases of type O,20 cases of type I,and 22 cases of type?.The classification results of 57 cases of IUA:12 cases of central type,17 cases of peripheral type and 28 cases of mixed type.2.The sensitivity of 2D-TVS and OmniView technology in the diagnosis of endometrial hyperplasia,endometrial polyps,uterine fetal material residues,endometrial cancer,submucosal uterine fibroids and IUA were 87.06%,86.11%,83.33%,62.50%,87.30%,80.70%and 87.06%,87.50%,83.33%,75.00%,93.65%and 94.74%,respectively.There were no statistically significant differences between the two methods in the diagnosis of endometrial hyperplasia,endometrial polyps,uterine fetal residue,endometrial cancer and submucosal fibroids(P>0,05),while there was a statistically significant difference in the diagnosis of IUA(P=0.01).3.In the classification of submucosal uterine fibroids,the sensitivity of 2D-TVS and OmniView technology for diagnosis of type 0,type I and type II were 90.48%,75.00%,59.10%and 95.24%,90.00%,90.91%,respectively.There was no significant difference in the diagnosis of type 0 and type ?(P=0.28?P=0.48),and there was a statistical difference in the diagnosis of type ?(P=0.04).4.In the classification of IUA,the sensitivity of 2D-TVS and OmniView technology for diagnosis of central,peripheral and mixed adhesions were 91.67%,64.71%,71.43%and 100%,88.24%,89.29%,respectively.There was a statistically significant difference between the two methods in the diagnosis of peripheral and mixed IUA(P=0.01?P<0.01),while no statistical difference in the diagnosis of central IUA(P>0.05).5.OmniView technology can vividly display the coronal plane of uterine cavity.In three-dimensional coronal plane,interrupted endometrial line,isoechoic lesion,irregular margin and abnormal morphology of uterine cavity were found in cases with IUA,of which angularity of the two sides of the endometrial cavities and abnormal morphology of uterine cavity were specific.Conclusions OmniView technology which has a high diagnostic sensitivity for uterine cavity disease can replace 2D-TVS as the preferred method,especially in the classification of submucosal uterine fibroids and IUA.In three-dimensional coronal plane,rugged bottom,angularity of the two sides and T-shaped of uterine cavity are typical features in IUA.Preoperative evaluation and postoperative review of IUA can be performed by using OmniView technology,which can reduce the risk of invasive uterine operation.