Purpose: To evaluate the use of vector driven 3D multi-planar ultrasound verses standard 2D imaging in the diagnosis of endometrial cavity masses during Saline Infused Sonography.
Methods and Materials: In a five-month period, patients undergoing a Saline Infused Sonogram (SIS) were evaluated on the GE Voluson Expert (GE Medical systems, Waukesha Wisconsin) ultrasound machine. The standard SIS protocol was followed for each case. 2D images were initially obtained, followed by 3D acquisitions. All data sets were stored on the system for further manipulation and evaluation. Upon completion of the SIS, the image information was processed and optimized. The processed 3D multi-planar images were added to the study for comparison with the 2D still images. All cases were performed and reviewed with a radiologist.
Results: The relevant 2D information was enhanced in almost every case by the 3D multi-planar images. Additional diagnostic information was obtained regarding size, shape and location of masses seen within the endometrial canal. The ability to scroll through the entire 3D dataset and accurately measure, along with the ability to rotate the images, gives a true multi-planar representation of the endometrium. In some cases the 2D images did not appreciate areas that the 3D multi-planar dataset was able to evaluate. The actual size and morphology of the masses were better represented. 2D imaging examines small sections at a time, therefore portions of the endometrium can go unevaluated, whereas with the 3D volume acquisition, the entire endometrium is interrogated and stored. The actual time to acquire a 3D data set is much shorter than serial 2D slices, minimizing patient discomfort. Reconstruction appears to add approximately 15 minutes to the end of the study to process the 3D volume data. Data processing must be preformed and reviewed on the Voluson system. Currently PACS systems are not compatible with the Voluson, therefore the 3D images can only be viewed as screen captures, removing the ability to further manipulate the data on PACS systems.
Conclusion: 3D imaging adds valuable information to SIS exams with the ability to re-manipulate data after acquisition and creating imaging planes not accessible in 2D imaging. 3D imaging decreases patient imaging time and patient discomfort. Currently the ability to process the data off line does not exist, so data reconstruction must be performed on the Voluson taking up valuable room time. (M.L., D.W. are consultants for GE Medical Systems.)