Min M Chou1, Jenn J Tseng, Yu C Yi, Wei C Chen, Esther Shih C Ho. 1. Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Chung Shan Medical University, Huang Kung University, Taichung, Taiwan. mmchou@vghtc.gov.tw
Abstract
OBJECTIVE: The purpose of this study was to investigate the use of a new ultrasound technique, termed 4-dimensional volume contrast imaging in coronal-plane to facilitate the early detection of interstitial pregnancy. STUDY DESIGN: A case of interstitial pregnancy was diagnosed accurately at 6 weeks of gestation with 4-dimensional transvaginal volume contrast imaging in coronal plane technology. A scan of the uterus revealed that the eccentric gestational sac was located in the right uterotubal junctional area, lying 1 cm outside the most upper lateral edge of the uterine cavity with thick endometrial echoes. RESULTS: After the appropriate counseling, the patient was treated with an ultrasonographically guided intracardiac injection of 2.5 mEq of potassium chloride followed by aspiration of the gestational sac. A transvaginal scan immediately after the procedure demonstrated a collapsed empty gestational sac. Three months after the conservative treatment, the serum beta-human chorionic gonadotropin level fell to 1.17 mIU/mL, and normal echotexture of the uterus was noted. CONCLUSION: Four-dimensional volume contrast imaging in coronal-plane technology provides scan planes that are not accessible by conventional 2-dimensional scanning, with enhanced tissue contrast resolution in region of interest. This new ultrasound technique has the potential to provide more accurate, inexpensive and less variable virtual reality image-guided interventional options through more realistic interaction with the virtualized in utero condition, particularly when 2-dimensional transvaginal scan fails to differentiate between interstitial, angular, and cornual pregnancies.
OBJECTIVE: The purpose of this study was to investigate the use of a new ultrasound technique, termed 4-dimensional volume contrast imaging in coronal-plane to facilitate the early detection of interstitial pregnancy. STUDY DESIGN: A case of interstitial pregnancy was diagnosed accurately at 6 weeks of gestation with 4-dimensional transvaginal volume contrast imaging in coronal plane technology. A scan of the uterus revealed that the eccentric gestational sac was located in the right uterotubal junctional area, lying 1 cm outside the most upper lateral edge of the uterine cavity with thick endometrial echoes. RESULTS: After the appropriate counseling, the patient was treated with an ultrasonographically guided intracardiac injection of 2.5 mEq of potassium chloride followed by aspiration of the gestational sac. A transvaginal scan immediately after the procedure demonstrated a collapsed empty gestational sac. Three months after the conservative treatment, the serum beta-human chorionic gonadotropin level fell to 1.17 mIU/mL, and normal echotexture of the uterus was noted. CONCLUSION: Four-dimensional volume contrast imaging in coronal-plane technology provides scan planes that are not accessible by conventional 2-dimensional scanning, with enhanced tissue contrast resolution in region of interest. This new ultrasound technique has the potential to provide more accurate, inexpensive and less variable virtual reality image-guided interventional options through more realistic interaction with the virtualized in utero condition, particularly when 2-dimensional transvaginal scan fails to differentiate between interstitial, angular, and cornual pregnancies.