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Myoma Imaging by Gynecologic Surgeons Training in Intraoperative Ultrasound Technique.

Abstract：

STUDY OBJECTIVE:To compare preoperative transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) with intraoperative ultrasound (IOUS) in surgeons first learning to use this technique. DESIGN:A prospective study of IOUS accuracy for mapping the size and location of myomas compared with TVUS or MRI (Canadian Task Force classification II-2). SETTING:Five University of California academic centers (Davis, Irvine, Los Angeles, San Diego, and San Francisco). PATIENTS:Twenty-six premenopausal women seeking uterine-sparing surgical treatment of myomas. Eligible participants could have no more than 6 myomas ≥2 cm and <10 cm and a uterine size no larger than 16 weeks by pelvic examination. INTERVENTIONS:Measurement of myomas by IOUS followed by radiofrequency ablation (RFA) of fibroids. MEASUREMENTS AND MAIN RESULTS:Eligible participants had to have imaging with TVUS or MRI within the last year to assess myoma characteristics. During the RFA operation, surgeons who had undergone a 1-day training on RFA and IOUS measured all myomas visualized with IOUS. Surgeons measured more myomas than were reported on MRI (12 on MRI and 16 on IOUS) or TVUS (41 on TVUS and 62 on IOUS) in all positions (anterior, posterior, lateral, and fundal). In particular, they identified more myomas <2 cm (4 on MRI, 9 on IOUS, 1 on TVUS, and 19 on IOUS). They located 2.3 times as many myomas in the anterior position as TVUS. For the myomas ≥2 cm identified by IOUS and MRI or IOUS and TVUS, there was no statistically significant difference in the mean myoma number or the mean myoma diameter measurements. CONCLUSION:Surgeons first learning to use IOUS detect the same number of myomas ≥2 cm as identified by TVUS and MRI and find a greater number of myomas <2 cm on IOUS compared with radiologist-reported TVUS.

journal_name

J Minim Invasive Gynecol

journal_title

Journal of minimally invasive gynecology

authors

Bent RE,Wilson MD,Jacoby VL,Varon S,Parvataneni R,Saberi N,Waetjen LE

doi

10.1016/j.jmig.2018.11.006

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

1139-1143

issue

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(18)31356-6

journal_volume

pub_type

临床试验,杂志文章,多中心研究

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Myoma Imaging by Gynecologic Surgeons Training in Intraoperative Ultrasound Technique.