Articles from BJOG

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Song, Y a; Yang, J a; Liu, Z b; Shen, K a;
Preoperative evaluation of endometrial carcinoma by contrast-enhanced ultrasonography.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):294-299, January 2009.
Abstract
Objective: To investigate the potential usefulness of contrast-enhanced ultrasonography in the preoperative evaluation of endometrial carcinoma and observe its enhancement pattern and time-intensity curve.Design: A prospective study.Setting: Gynaecological department of a college hospital.Population: A total of 35 women diagnosed with endometrial carcinoma.Methods: The patients were evaluated with real-time grey-scale contrast-enhanced ultrasonography. In 21 women, the parameters of time-intensity curve were compared between the endometrial lesion and normal myometrium. Findings about the depth of myometrial invasion on sonograms were compared with histological findings.Main outcome measures: Enhancement pattern, parameters of time-intensity curve, depth of myometrial invasion detected on sonograms.Results: In visual evaluation, the brightness of the power Doppler signal and the amount of recognisable vascular areas increased in each tumour after contrast agent administration. Feeding vessels of the tumour were shown in 77.1% (27/35) of women. The other 22.9% (8/35) of women revealed that the signals were first visualised in the central portion of the tumour. The arrival time and peak time of endometrial lesion tended to be shorter than normal myometrium. The tumours started to enhance earlier than or at the same time as myometrium in 90.5% (19/21) of women. The peak intensity, enhancement intensity, and rising rate were higher in endometrial lesion than normal myometrium. There was no myometrial invasion in eight women, inner half myometrial invasion in 19 women and the outer half myometrial invasion in eight women. The corresponding values for ultrasound were 9, 17, and 9. The sensitivity of contrast-enhanced ultrasonography in detecting deep invasion was 75.0%, while the specificity was 88.9%, and the accuracy was 85.7%. The overall accuracy of assessment of myometrial invasion was 68.6%.Conclusion: There is some benefit in contrast-enhanced ultrasonography of endometrial carcinoma. It may provide better information in tumour imaging. Large studies are needed to determine the appropriate use and benefit of this new procedure.

Rousian, M ; Verwoerd-Dikkeboom, C M ; Koning, A HJ ; Hop, W C et al
Early pregnancy volume measurements: validation of ultrasound techniques and new perspectives.
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):278-285, January 2009.
Abstract
Objective: To investigate accuracy and reliability of four different ultrasound-related volume-measuring methods.Design: Observational study.Setting: Both in vitro and in vivo.Population or Sample: Ten phantoms for in vitro measurements and 28 pregnancies with gestational ages ranging from 6 to 11 weeks for in vivo measurements were included.Methods: Three-dimensional (3D) ultrasound images of phantoms (with known variable contents) and yolk sacs were used to calculate volumes using four different methods: Virtual Organ Computed-Aided AnaLysis (VOCAL), inversion mode, Sono Automatic Volume Calculation (SonoAVC) and V-Scope. V-Scope is a newly developed 3D volume visualisation application using a Barco I-Space virtual reality system. Intra- and interobserver agreement was established by calculating intraclass correlation coefficients (ICC).Main outcome measure: Evaluation of accuracy and reliability by comparing the different techniques with true volumes (in vitro) and with each other (in vitro and in vivo).Results: In the in vitro study, volume measurements by VOCAL, inversion mode and V-Scope proved to be accurate. SonoAVC measurements resulted in a substantial systematic underestimation. Correlation coefficients of measured versus true volumes were excellent in all four techniques. For all techniques, an intra- and interobserver agreement of at least 0.91 was found. Yolk sac measurements by the different techniques proved to be highly correlated (ICCs > 0.91).Conclusions: We demonstrated that VOCAL, inversion mode and V-Scope can all be used to measure volumes of hypoechoic structures. The newly introduced V-Scope application proved to be accurate and reliable.

Vincent, K ; Moore, J ; Kennedy, S ; Tracey, I
Blood oxygenation level dependent functional magnetic resonance imaging: current and potential uses in obstetrics and gynaecology.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):240-246, January 2009.
Abstract
Blood-oxygenation-level-dependent functional magnetic resonance imaging is a noninvasive technique that has become increasingly popular in the neurosciences. It measures the proportion of oxygenated haemoglobin in specific areas of the brain, mirroring blood flow and therefore function. Here we review how the findings from functional studies impact on areas of gynaecological practice as diverse as chronic pain, continence, and premenstrual dysphoric disorder. Finally we review some of the more novel applications of the technique, such as imaging of pelvic floor function and the effects of hypoxia on the fetus.


Louwers, J A ; Kocken, M ; Harmsel, W Ater ; Verheijen, R HM e
Digital colposcopy: ready for use? An overview of literature.[Review]
BJOG: An International Journal of Obstetrics & Gynaecology. 116(2):220-229, January 2009.
Abstract
The aims of this review were to summarise the various methods of digital colposcopy and to provide an overview of their efficacy. We conducted a literature search and focused on papers that described a technique for colposcopy, other than conventional colposcopy, and compared this with conventional colposcopy and/or histology and included digitalisation of the process. All papers have been classified in one of the following categories: digital imaging and telecolposcopy, spectroscopy, computerised colposcopy, optical coherence tomography and confocal microcolposcopy. Among the most promising developments is spectroscopy, allowing a more or less automated analysis and interpretation of the colposcopic image.