Advertisement

3D transvaginal sonography in obstetrics and gynecology

Published:September 15, 2017DOI:https://doi.org/10.1016/j.ajog.2017.09.004
      To the Editors:
      We certainly agree with the authors, Lee and Yoon,
      • Lee S.R.
      • Yoon H.N.
      Ureteral stone diagnosed with three-dimensional transvaginal ultrasonography.
      in that 3-dimensional transvaginal ultrasonography (3D TVS) clearly offers additional clinical value as a diagnostic imaging tool, well beyond 2D TVS. The identification of a ureteral calculus within the ureter provides a good example of this value; such use should be encouraged and broadened. One can even say that, with the confirmatory diagnosis from the use of 3D TVS, the other imaging modalities (eg, computed tomography) may not have even been necessary to use in this case.
      In fact, the authors of 1 of the references that was cited in this article
      • Pateman K.
      • Mavrelos D.
      • Hoo W.L.
      • Holland T.
      • Naftalin J.
      • Jurkovic D.
      Visualization of ureters on standard gynecological transvaginal scan: a feasibility study.
      stated that “visualization of the ureters could be incorporated into standard gynecological pelvic examination without significant increase in the examination time.” Those authors stated that this could be done “particularly in women with a history of pelvic pain.” Moreover, we have many similar examples of the clinical value of 3D TVS for other routine gynecologic diagnoses.

      References

        • Lee S.R.
        • Yoon H.N.
        Ureteral stone diagnosed with three-dimensional transvaginal ultrasonography.
        Am J Obstet Gynecol. 2017; 217: 88.e1-88.e2
        • Pateman K.
        • Mavrelos D.
        • Hoo W.L.
        • Holland T.
        • Naftalin J.
        • Jurkovic D.
        Visualization of ureters on standard gynecological transvaginal scan: a feasibility study.
        Ultrasound Obstet Gynecol. 2013; 41: 696-701

      Linked Article

      • Ureteral stone diagnosed with 3-dimensional transvaginal ultrasonography
        American Journal of Obstetrics & GynecologyVol. 217Issue 1
        • Preview
          A 45-year-old woman presented with low abdominal and low back pain, which had slowly increased over 3 months. Two-dimensional transvaginal sonography revealed an anechoic cylindrical shadow with a round isoechoic mass accompanied by posterior acoustic shadowing (Figure 1, A). The B-mode histogram revealed the same brightness in the contents of both the urinary bladder and the cylindrical structure, suggesting that the cylindrical structure was a dilated ureter containing urine (Figure 1, B). Three-dimensional images obtained with the be Crystal Vue (Samsung Medison Ltd, Seoul, Republic of Korea) mode and the Realistic Vue (Samsung Medison Ltd) function clearly visualized the internal and external contours of the urinary bladder and dilated distal ureter obstructed with a ureteral stone at the ureterovesical junction (Figure 1, C).
        • Full-Text
        • PDF
      • Reply
        American Journal of Obstetrics & GynecologyVol. 218Issue 1
        • Preview
          We appreciate the insightful comments expressed by Drs Levine and Fernandez regarding our recent report on the ureter stone diagnosed with 3-dimensional (3D) transvaginal ultrasonography. We absolutely agree with the authors’ opinion that the 3D sonography provided additional useful information to the 2-dimensional sonography. As Drs Levine and Fernandez commented, the imaging studies that were performed to confirm the diagnosis of distal ureteral stone in our case might not be needed in other cases, considering the additional cost and radiation exposure.
        • Full-Text
        • PDF