| 1. |
- Jokubkiene, Ligita, et al.
(författare)
-
Number of antral follicles, ovarian volume, and vascular indices in asymptomatic women 20 to 39 years old as assessed by 3-dimensional sonography: a prospective cross-sectional study.
- 2012
-
Ingår i: Journal of Ultrasound in Medicine. - 1550-9613. ; 31:10, s. 1635-1649
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Our aim was to elicit data representative of normal findings on 3-dimensional (3D) transvaginal gray-scale and power Doppler sonography of ovaries in women of fertile age. Methods: A total of 303 gynecologically asymptomatic white women 20 to 39 years old with spontaneous regular menstrual cycles were examined with transvaginal 3D gray-scale and power Doppler sonography on cycle days 4 to 8. We used a 6- to 12-MHz transducer. The ovarian volume, number and volume of antral follicles of 2 mm or larger, vascularization index, flow index, and vascularization-flow index were calculated using dedicated software. Results are presented separately for women with follicles of 2.0 to 10.0 mm and for those with at least 1 follicle larger than 10.0 mm for 3 age groups: 20 to 29, 30 to 34, and 35 to 39 years. Results: There were 214 women (71%) with follicles of 2.0 to 10.0 mm and 89 (29%) with follicles larger than 10.0 mm. In women with follicles of 2.0 to 10.0 mm, the right ovary was on average 0.8 cm(3) larger and contained on average 1.2 more follicles than the left one. The ovarian volume, number of follicles, and total follicular volume decreased significantly with age in both ovaries (P = .000-.029): for the right ovary ovarian volume, the median (range) decreased from 8.4 (3.7-17.3) cm(3) at 20 to 29 years to 6.5 (2.4-12.7) cm(3) at 35 to 39 years, the number of follicles from 14 (1-32) at 20 to 29 years to 8 (1-21) at 35 to 39 years, and the total follicular volume from 1.08 (0.01-3.10) cm(3) at 20 to 29 years to 0.84 (0.03-2.00) cm(3) at 35 to 39 years. The size of the largest follicle and the vascular indices manifested no clear changes with age in any ovary. In women with follicles larger than 10 mm, the number of follicles decreased with age in both ovaries. Conclusions: We have elicited data representative of normal findings on 3D trans-vaginal sonography of ovaries in gynecologically asymptomatic white women of fertile age. Our gray-scale sonographic results may be used as reference values for general gynecology in populations similar to ours. Vascular indices must be interpreted with caution because of difficulties with standardization.
|
|
| 2. |
- Jokubkiene, Ligita, et al.
(författare)
-
Ovarian size and vascularization as assessed by three-dimensional grayscale and power Doppler ultrasound in asymptomatic women 20-39 years old using combined oral contraceptives
- 2012
-
Ingår i: Contraception. - : Elsevier BV. - 0010-7824. ; 86:3, s. 257-267
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study is to estimate ovarian volume, number and volume of antral follicles, and ovarian power Doppler vascular indices as assessed by three-dimensional (3D) transvaginal grayscale and power Doppler ultrasound in women using combined oral contraceptives (COC). Study Design: Two hundred thirteen gynecologically asymptomatic women 20-39 years old using COC were examined with transvaginal 3D grayscale and power Doppler ultrasound on cycle day 4-8 (first cycle day is first day of withdrawal bleeding). We used a Voluson E8 ultrasound system with a 6-12-MHz transvaginal transducer. Ovarian volume, number and volume of antral follicles >= 2 mm, vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were calculated using the virtual organ computer-aided analysis (VOCAL (TM)) and sonography-based automated volume calculation (SonoAVC (TM)) software. Results are described separately for women with follicles 2.0-10.0 mm and for those with at least one follicle >10.0 mm for two age groups: 20-29 years (n=166) and 30-39 years (n=47). Results are also compared between women on monophasic (n=151) and triphasic (n=59) COC, and between women using COC with older (n=110) and newer (n=100) progestins and different doses of estrogen. Results: One hundred eighty-nine (89%) women had follicles 2.0-10.0 mm, and 24 (11%) had follicle(s) >10.0 mm. The proportion of women with follicle(s)>10.0 mm did not differ between women with different types of COC. In women with follicles 2.0-10.0 mm, the right ovary was larger (mean difference 0.5 cm(3) [95% confidence interval 0.22-0.82]) and contained more follicles (mean difference 1.5 [0.52-2.56]) than the left one in the age group 20-29 years. The same differences between the right and left ovary were seen in women 30-39 years old, but they were not statistically significant. In both ovaries, the number of antral follicles 2.0-10.0 mm [median (range)] was significantly higher in women 20-29 than in those 30-39 years old [11(2-34) vs. 8(1-26), p=.012 for the right ovary; 9 (0-28) vs. 7(1-28), p=.035 for the left ovary]. Ovarian volume tended to be smaller in women 20-29 than in those 30-39 years old, but the differences were not statistically significant. Size of the largest follicle, total follicular volume and vascular indices manifested no clear differences between the age groups. For all 378 ovaries with follicles <= 10 mm, ovarian volume ranged from 1 to 16 cm(3) (median 5), total follicular volume ranged from 0.03 to 2.7 cm(3) (median 0.7), VI ranged from 0.0 % to 13.4% (median 0.97), FI ranged from 0 to 38 (median 25), and VFI ranged from 0.0 to 4.7 (median 0.3). Conclusions: Our results show estimated ranges of 3D grayscale and power Doppler ultrasound measurements in ovaries of women using COC. (C) 2012 Elsevier Inc. All rights reserved.
|
|
| 3. |
- Jokubkiene, Ligita, et al.
(författare)
-
Prevalence of extrauterine pelvic lesions at transvaginal ultrasound examination of asymptomatic women 20-39 years old.
- 2014
-
Ingår i: Ultrasound in Obstetrics & Gynecology. - : Wiley. - 1469-0705 .- 0960-7692. ; 44:2, s. 228-237
-
Tidskriftsartikel (refereegranskat)abstract
- To estimate the prevalence of extrauterine pelvic lesions at transvaginal ultrasound examination of gynecologically asymptomatic women of fertile age and to compare this prevalence between women with spontaneous menstrual cycles, those using combined oral contraceptive pills (COC) or a gestagen intrauterine contraceptive device (IUD).
|
|
| 4. |
- Jokubkiene, Ligita
(författare)
-
Three-dimensional ultrasound studies of normal and abnormal ovaries
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aims of this work were: 1) to estimate the number of follicles, ovarian volume and power Doppler vascular indices and their changes with age using three-dimensional (3D) transvaginal grey-scale and power Doppler ultrasound in asymptomatic women of fertile age either with natural menstrual cycles or using combined oral contraceptives, and 2) to determine whether tumour vascularity, assessed by 3D power Doppler ultrasound, can help discriminate between benign and malignant ovarian tumours. A group of 303 gynaecologically asymptomatic women, aged 20–39 years with normal menstrual cycles (NMC) and another group of 213 women aged 20–39 years using combined oral contraceptives (COC) were examined using two-dimensional (2D) and 3D transvaginal ultrasound once between cycle day 4 and 8. Ovarian volume and the number of antral follicles were found to decrease with age, while no unequivocal changes in vascular indices were seen in women with NMC. In women using COC the number of antral follicles also decreased with age. The ovarian volume and the number of follicles were determined for different age groups, and these results can be used as reference data. A group of women with ovarian tumours (n=106) was examined using 2D and 3D transvaginal ultrasound. Tumour vascularization was assessed using 3D power Doppler ultrasound in the whole tumour and in a 5-cm3 spherical sample in the most vascularized part of the tumour. A logistic regression model with only grey-scale ultrasound variables (size of the largest solid component, wall irregularity, mean diameter of the lesion) was created to predict malignancy. The flow index in the 5-cm3 sample and the branching of vessels in the whole tumour provided additional information to the grey-scale model, but the diagnostic performance was only slightly improved.
|
|
| 5. |
- Opolskiene, Gina, et al.
(författare)
-
Three-dimensional ultrasound imaging for discrimination between benign and malignant endometrium in women with postmenopausal bleeding and sonographic endometrial thickness of at least 4.5 mm.
- 2010
-
Ingår i: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. - : Wiley. - 1469-0705. ; 35, s. 94-102
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine whether endometrial volume or power Doppler indices as measured by three-dimensional (3D) ultrasound imaging can discriminate between benign and malignant endometrium, to compare their diagnostic performance with that of endometrial thickness measurement using two-dimensional (2D) ultrasound examination, and to determine whether power Doppler indices add any diagnostic information to endometrial thickness or volume. METHODS: Sixty-two patients with postmenopausal bleeding and endometrial thickness >/= 4.5 mm underwent transvaginal 2D gray-scale and 3D power Doppler ultrasound examination of the corpus uteri. The endometrial volume was calculated, along with the vascularization index (VI), flow index and vascularization flow index (VFI) in the endometrium and in a 2-mm 'shell' surrounding the endometrium. The 'gold standard' was the histological diagnosis of the endometrium obtained by hysteroscopic resection of focal lesions, dilatation and curettage or hysterectomy. Receiver-operating characteristics (ROC) curves were drawn for all measurements to evaluate their ability to distinguish between benign and malignant endometrium. Multivariate logistic regression analysis was used to create mathematical models to estimate the risk of endometrial malignancy. RESULTS: There were 49 benign and 13 malignant endometria. Endometrial thickness and volume were significantly larger in malignant than in benign endometria, and flow indices in the endometrium and endometrial shell were significantly higher. The area under the ROC curve (AUC) of endometrial thickness was 0.82, that of endometrial volume 0.78, and that of the two best power Doppler variables (VI and VFI in the endometrium) 0.82 and 0.82. The best logistic regression model for predicting malignancy contained the variables endometrial thickness (odds ratio 1.2; 95% CI, 1.04-1.30; P = 0.004) and VI in the endometrial 'shell' (odds ratio 1.1; 95% CI, 1.02-1.23; P = 0.01). Its AUC was 0.86. Using its mathematically optimal risk cut-off value (0.22), the model correctly classified seven more benign cases but two fewer malignant cases than the best endometrial thickness cut-off (11.8 mm). Models containing endometrial volume and flow indices performed less well than did endometrial thickness alone (AUC, 0.79 vs. 0.82). CONCLUSIONS: The diagnostic performance for discrimination between benign and malignant endometrium of 3D ultrasound imaging was not superior to that of endometrial thickness as measured by 2D ultrasound examination, and 3D power Doppler imaging added little to endometrial thickness or volume. Copyright (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd.
|
|
| 6. |
- Osser, O Vikhareva, et al.
(författare)
-
Cesarean section scar defects: agreement between transvaginal sonographic findings with and without saline contrast enhancement.
- 2010
-
Ingår i: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. - : Wiley. - 1469-0705. ; 35:1, s. 75-83
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine the agreement between transvaginal ultrasound examinations performed before and at saline contrast sonohysterography (SCSH) with regard to number, size and shape of Cesarean section (CS) scar defects. METHODS: In all, 108 women underwent transvaginal ultrasound examination with SCSH at least 6 months after CS: 68 had undergone one CS, 32 two CSs and eight women had undergone at least three CSs. The ultrasound examiner was blinded to the number of CSs and to the obstetric history. The number and shape of CS scar defects were determined subjectively, and any scar defect was estimated subjectively to be large or not large. Measurements of the scar defects were also taken. Results obtained before and at SCSH were compared. RESULTS: Most scar defects were triangular in shape. The shape did not change at SCSH, but the ultrasound examiner found it easier to delineate the borders of the scar defects at SCSH than at unenhanced ultrasound examination. More scar defects were seen and more scar defects were classified as large at SCSH than before: among the 100 women who had undergone one or two CSs, 16 additional women had large defects at SCSH, whereas no woman with a large defect before SCSH had no defect or only a small defect at SCSH. The length and height of the defects were larger at SCSH than before: mean difference 2 mm and 1 mm in women who had undergone one CS, and mean difference 4 mm and 2 mm in the lowest-positioned scar in women who had undergone two CSs. CONCLUSIONS: In non-pregnant women CS scars were better evaluated at SCSH than at unenhanced ultrasound examination, because the demarcations of scar defects were more clearly delineated at SCSH than before. More defects were detected and more defects were classified as large at SCSH.
|
|
| 7. |
|
|
| 8. |
- Zannoni, L, et al.
(författare)
-
Intra- and inter-observer reproducibility of assessment of Doppler ultrasound findings in adnexal masses.
- 2013
-
Ingår i: Ultrasound in Obstetrics & Gynecology. - : Wiley. - 1469-0705 .- 0960-7692. ; 42:1, s. 93-101
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To estimate intra- and inter-observer reproducibility and reliability of assessment of the color content in adnexal masses at color/power Doppler ultrasound examination for observers with different levels of experience, and to determine if they change after a consensus meeting. Methods: Digital clips with color/power Doppler information of 103 adnexal masses were evaluated independently four times, twice before and twice after a consensus meeting, by four experienced and three less experienced ultrasound examiners. The color content of the adnexal mass was estimated using the International Ovarian Tumor Analysis color score and a 100 mm visual analogue scale (VAS score). Intraobserver repeatability was estimated for each observer. Interobserver agreement was estimated for the four most experienced observers (six pairs), for the three less experienced observers (three pairs), and for four other pairs of observers, each pair consisting of one of the experienced and one of the less-experienced observers. Results: Intra- and inter-observer agreement for the color score was moderate to very good, percentage agreement ranging from 48% to 82.5% (Kappa 0.52-0.82) before and from 59% to 90% (Kappa 0.60-0.88) after the consensus meeting. For seven of 13 pairs of observers, interobserver agreement improved after the consensus meeting. Intra-observer intraclass correlation coefficient (ICC) values for the VAS score ranged from 0.80 to 0.92 before and from 0.75 to 0.94 after the consensus meeting, but limits of agreement were wide (+/-20-35 mm). For six of the seven observers the ICC values were higher after the consensus meeting than before. Inter-observer ICC values for the VAS score ranged from 0.77 to 0.88 before and from 0.77 to 0.91 after the consensus meeting, but limits of agreement were wide (+/-30-40 mm). For ten of 13 pairs of observers the ICC values improved after the consensus meeting. Conclusions: Intra-and inter-observer agreement for the color score was good, especially after the consensus meeting, but there is room for improvement. VAS score results varied substantially within and between observers both before and after the consensus meeting. General consensus needs to be reached about how to interpret color/power Doppler ultrasound findings in adnexal masses. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
|
|
