Advertisement

Reply

Published:September 15, 2017DOI:https://doi.org/10.1016/j.ajog.2017.09.005
      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.
      Although not necessary in every case, 3D sonography is highly useful in the differential diagnosis of congenital uterine anomalies because the coronal image of 3D sonography provides both the outline of endometrial cavity and external fundal contour of the uterus.
      Some authors reported the accuracy of 3D sonography to be comparable with that of magnetic resonance imaging.
      • Graupera B.
      • Pascual M.A.
      • Hereter L.
      • et al.
      Accuracy of three-dimensional ultrasound compared with magnetic resonance imaging in diagnosis of Müllerian duct anomalies using ESHRE-ESGE consensus on the classification of congenital anomalies of the female genital tract.
      3D sonography also enables doctors to confirm the relationship of the leiomyoma to the endometrium. The main body of leiomyoma can be located without performing a sonohysterogram, which can sometimes be painful for the patient. We also think the rendered 3D sonography is also helpful in the removal of intrauterine lesions, such as endometrial polyps or injuries, that are caused by impacted intrauterine devices with various shapes.
      • Graupera B.
      • Hereter L.
      • Pascual M.A.
      • et al.
      Normal and abnormal images of intrauterine devices: role of three-dimensional sonography.
      The more precise localization of intrauterine lesions enables targeted curettage without requiring an office hysteroscopy. However, we look forward to performing a more extensive study that will evaluate the usefulness of 3D sonography in the diagnosis of gynecologic diseases.

      References

        • Graupera B.
        • Pascual M.A.
        • Hereter L.
        • et al.
        Accuracy of three-dimensional ultrasound compared with magnetic resonance imaging in diagnosis of Müllerian duct anomalies using ESHRE-ESGE consensus on the classification of congenital anomalies of the female genital tract.
        Ultrasound Obstet Gynecol. 2015; 46: 616-622
        • Graupera B.
        • Hereter L.
        • Pascual M.A.
        • et al.
        Normal and abnormal images of intrauterine devices: role of three-dimensional sonography.
        J Clin Ultrasound. 2012; 40: 433-438

      Linked Article

      • 3D transvaginal sonography in obstetrics and gynecology
        American Journal of Obstetrics & GynecologyVol. 218Issue 1
        • Preview
          We certainly agree with the authors, Lee and Yoon,1 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.
        • Full-Text
        • PDF