Advertisement

Diagnostischer einsatz bei anderen gynäkologischen erkrankungen

  • G. Bogner
  • R. Gruber

Auszug

Die transvaginale farbkodierte Dopplersonographie ist auch im 1. Trimenon der Schwangerschaft zur Beurteilung verschiedener physiologischer und pathologischer Zustände einsetzbar. Wie bei den meisten gynäkologischen Erkrankungen ist der Farbdoppler ein Zusatzbefund im Abklärungsmanagement, der nur im Kontext mit den klinischen Befunden interpretiert werden kann. Grundlagen der Anwendung und Sicherheitsaspekte der Dopplersonographie (Kap. 7) und der Physiologie der Durchblutung im 1. Trimenon werden vorausgesetzt (Kap. 12 u. 25). Während sich das Kap. 12 überwiegend mit Physiologie und mit der dopplersonographischen Untersuchung des Embryos im 1. Trimenon und der daraus ableitbaren Erkenntnisse über fetale Erkrankungen beschäftigt, wird der Schwerpunkt in diesem Kapitel auf Pathologie der gestörten Schwangerschaft gelegt. Für die Anwendung des Doppiers im Management eignen sich:
  1. 1.

    die Extrauteringravidität

     

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Achiron R, Goldenberg M, Lipitz S, Mashiach S (1993) Transvaginal duplex Doppier ultrasonography in bleeding patients suspected of having residual trophoblastic tissue. Obstet Gynecol 81: 507–511PubMedGoogle Scholar
  2. Achiron R, Grisaru D, Galan-Porat N, Lipitz S (1996) Tamoxifen and the uterus: An old drug tested by new modalities. Ultrasound Obstet Gynecol 7(1996): 374–378PubMedCrossRefGoogle Scholar
  3. Achiron R, Lipitz S, Sivan E, Goldenberg M, Horovitz A, Frenkel Y, Mashiach S (1995) Changes mimicking endometrial neoplasia in postmenopausal, tamoxifen-treated women with breast cancer: A transvaginal Doppler study. Ultrasound Obstet Gynecol 6:116–120PubMedCrossRefGoogle Scholar
  4. Alcazar JL, Castillo G, Minguez JA, Galan MJ (2003) Endometrial blood flow mapping using transvaginal power Doppler sonography in women with postmenopausal bleeding and thickened endometrium. Ultrasound Obstet Gynecol 21(6):583–588PubMedCrossRefGoogle Scholar
  5. Alcazar JL, Laparte C, Lopez-Garcia G (1996) Corpus luteum blood flow in abnormal early pregnancy. J Ultrasound Med 15:645–649PubMedGoogle Scholar
  6. Alcazar JL, Ortiz CA (2002) Transvaginal color Doppler ultrasonography in the management of first-trimester spontaneous abortion. Eur J Obstet Gynecol Reprod Biol 102(1):83–87PubMedCrossRefGoogle Scholar
  7. Alcazar JL, Castillo G, Jurado M, Lopez-Garcia G (2003) Intratumoral blood flow in cervical cancer as assessed by transvaginal color Doppler ultrasonography: Correlation with tumor characteristics. Int J Gynecol Cancer 13(4):510–514PubMedCrossRefGoogle Scholar
  8. Amit A, Weiner Z, Ganem N, Kerner H, Edwards CL, Kaplan A, Beck D (2000) The diagnostic value of power Doppler measurements in the endometrium of women with postmenopausal bleeding. Gynecol Oncol 77(2): 243–247PubMedCrossRefGoogle Scholar
  9. Atri M (2003) Ectopic pregnancy versus corpus luteum cyst revisited: best Doppler predictors. J Ultrasound Med 22(11):1181–1184PubMedGoogle Scholar
  10. Atri M, Chow CM, Kintzen G, Gillett P, Aldis AA, Thibodeau M, Reinhold C, Bret PM (2001) Expectant treatment of ectopic pregnancies: clinical and sonographic predictors. Am J Roentgenol 176(1):123–127Google Scholar
  11. Bazot M, Darai E, Rouger J, Detchev R, Cortez A, Uzan S (2002) Limitations of transvaginal sonography for the diagnosis of adenomyosis with histophathological correlation Ultrasound Obstet Gynecol 20(6): 605–611PubMedCrossRefGoogle Scholar
  12. Bonilla-Musoles FM, Ballester MJ, Tarin JJ, Raga F, Osborne NG, Pellicer A (1995) Does transvaginal color Doppler sonography differentiate between developing and involuting ectopic pregnancies? J Ultrasound Med 14:175–181PubMedGoogle Scholar
  13. Bonilla-Musoles F, Marti MC, Ballester MJ, Raga F, Osborne NG (1995) Normal uterine arterial blood flow in postmenopausal women assessed by transvaginal color Doppler sonography: The effect of hormone replacement therapy. J Ultrasound Med 14:497–501PubMedGoogle Scholar
  14. Botsis D, Christodoulakos G, Papagianni V, Lambrinoudaki I et al. (2006) The effect of raloxifene and tibolone on the uterine Blood flOw and endometrial thickness: a transvaginal Doppler study. Maturitas 20; 53(3):362–368CrossRefGoogle Scholar
  15. Bourne TH, Campbell S, Steer CV, Royston P, Whitehead MI, Collins WP (1991) Detection of endometrial cancer by transvaginal ultrasonography with color flow imaging and blood flow analysis: A preliminary report. Gynecol Oncol 40:253–259PubMedCrossRefGoogle Scholar
  16. Bourne TH, Campbell S, Steer CV, Whitehead MI, Collins WP (1989) Transvaginal colour flow imaging: A possible new screening technique for ovarian cancer. Br Med J 299:1367–1370Google Scholar
  17. Brown DL, Doubilet PM (1994)Transvaginal sonography for diagnosing ectopic pregnancy: Positivity criteria and performance characteristics. J Ultrasound Med 13:259–266PubMedGoogle Scholar
  18. Brun JL, Descat E, Boubli B, Dallay D (2006) Endometrial hyperplasia: A review. J Gynecol Obstet Biol Reprod 35(6)542–550Google Scholar
  19. Cacciatore B, Korhonen J, Stenamn UH, Ylöstalo P (1995) Transvaginal sonography and serum hCG in monitoring of presumed ectopic pregnancies selected for expectant management. Ultrasound Obstet Gynecol 5:297–300PubMedCrossRefGoogle Scholar
  20. Carter JR, Lau MF, Saltzman AK (1994) Gray scale and color flow Doppler characterization of uterine tumors. J Ultrasound Med 13:835–840PubMedGoogle Scholar
  21. Chan FJ, Chau MT, Pun TC, Lam C, Ngan HYS, Wong RLC (1995) A comparison of colour Doppler sonography and the pelvic arteriogram in assessment of patients with gestational trophoblastic disease. Br J Obstet Gynecol 102:720–725Google Scholar
  22. Clark TJ, Neelakantan D, Gupta JK (2006) The management of endometrial hyperplasia: an evaluation of current practice. Eur J Obstet Gynecol 125(2):259–264CrossRefGoogle Scholar
  23. Cohen I, Rosen D, Trepper R et al. (1993) Ultrasonographic evaluation of the endometrium and correlation with endometrial sampling in postmenopausal patients treated with Tamoxifen J.Ultrasound Med 5:275–278Google Scholar
  24. DeSmet F, De Brabanter J, Van den Bosch T, Pochet N et al. (2006) New models to predict depth of infiltration in endometrial carcinoma based on transvaginal sonography. Ultrasound Obstet Gynecol 27(6):664–671CrossRefGoogle Scholar
  25. Dialani V, Levine D (2004) Ectopic pregnancy: a review. Ultrasound Q 20(3):105–117PubMedCrossRefGoogle Scholar
  26. Emoto M, Tamura R, Shirota K, Hachisuga T, Kawarabayashi T (2002) Clinical usefullness of color Doppler ultrasound in patients with endometrial hyperplasia and carcinoma. Cancer 94(3):700–706PubMedCrossRefGoogle Scholar
  27. Fedele L, Bianchi S, Dorta M, Zanotti F, Brioschi D, Carinelli S (1992) Transvaginal ultrasonography in the differential diagnosis of adenomyoma versus leiomyoma. Am J Obstet Gynecol 167:603–606PubMedGoogle Scholar
  28. Frates MC, Doubilet PM, Durfee SM, Di Salvo DN, Laing FC, Brown DL, Benson CB, Hill JA (2001) Sonographic and Doppler characteristics of the corpus luteum: can they predict pregnancy outcome? J Ultrasound Med 20(8):821–827PubMedGoogle Scholar
  29. Getpook C, Wattanakumtornkul S (2006) Endometrial thickness screening in premenopausal women with abnormal uterine bleeding. J Obstet Gynaecol Res 32(6)588–592PubMedCrossRefGoogle Scholar
  30. Hata K, Hata T, Maruyama R, Hirai M (1997) Uterine sarcoma: Can it be differentiated from uterine leiomyoma with Doppler ultrasonography? A preliminary report. Ultrasound Obstet Gynecol 9:101–104PubMedCrossRefGoogle Scholar
  31. Hirai M, Shibata K, Sagai H, Sekija S, Goldberg BB (1995) Transvaginal pulsed and color Doppler sonography for the evaluation of adenomyosis. J Ultrasound Med 14:529–532PubMedGoogle Scholar
  32. Jauniaux E, Johns J, Burton GJ (2005) The role of ultrasound imaging in diagnosing and investigating early pregnancy failure, a review. Ultrasound Obstet Gynecol 25(6):613–624PubMedCrossRefGoogle Scholar
  33. Kazandi M, Aksehirli S, Cirpan T, Akercan F (2003) Transvaginal sonography combined with saline contrast sonohysterography to evacuate the uterine cavity in patients with abnormal uterine bleeding and postmenopausal endometrium more than 5 mm. Eur J Gynaecol Oncol 24(2): 185–190PubMedGoogle Scholar
  34. Kemp B, Funk A, Hauptmann S, Rath W. (1997) Doppler sonographic criteria for viability in symptomless ectopic pregnancies. Lancet 349(9060):1220–1221PubMedCrossRefGoogle Scholar
  35. Karlsson B, Granberg S, Wikland M, Ryd W, Norström A (1993) Endovaginal scanning of the endometrium compared to cytology and histology in women with postmenopausal bleeding. Gynecol Oncol 50:173–178PubMedCrossRefGoogle Scholar
  36. Kurjak A, Kupesic S (1995) Transvaginal color Doppler and pelvic tumor vascularity: lessons learned and future challenges. Ultrasound Obstet Gynecol 6:145–159PubMedCrossRefGoogle Scholar
  37. Kurjak A, Shalan H, Sosic A, Benic S, Zudenigo D, Kupesic S, Predanic M (1993) Endometrial carcinoma in postmenopausal women: Evaluation by transvaginal color Doppler ultrasonography. Obstet Gynecol 169:1597–1603Google Scholar
  38. Kurjak A, Zalud I, Jurkovic D, Miljan M (1989) Transvaginal color Doppler for the assessment of pelvic circulation. Acta Obstet Gynecol Scand 68:131–135PubMedCrossRefGoogle Scholar
  39. Lahti E, Blanco G, Kaupilla A, Apaja-Sarkkinen M, Taskinen PJ, Laatikainen T (1993) Endometrial changes in postmenopausal breast cancer patients receiving Tamoxifen. Obstet Gynecol 81:660–664PubMedGoogle Scholar
  40. Lazar F, Costa-Paiva L, Pinto-Neto AM, Martinez EZ (2004) Caritid and uterine vascular resistance in short-term hormone replacement therapy postmenopausal users. Maturitas 20; 48(4):472–478CrossRefGoogle Scholar
  41. Luise C, Jermy K, May C, Costello G, Collins WP, Bourne TH (2002) Outcome of expectant management of spontaneous first trimester miscarriage: observational study. BMJ 324(7342):873–875PubMedCrossRefGoogle Scholar
  42. Machtinger R, Korach J, Padoa A, Fridman E et al. (2005) Transvaginal ultrasound and diagnostic hysteroscopy as a predictor of endometrial polyps: risk factors for premalignancy and malignancy: Int J Gynecol Cancer 15(2):325–328PubMedCrossRefGoogle Scholar
  43. Minagawa Y, Sato S, Ito M, Onohara Y, Nakamoto S, Kigawa J (2005) Transvaginal ultrasonography and endometrial cytology as a diagnostic schema for endometrial cancer: Gynecol Obstset Invest 59(3):149–154CrossRefGoogle Scholar
  44. Montgomery BE, Daum GS, Dunton CJ (2004) Endometrial hyperplasia: a review. Obstet Gynecol Surv 59(5):368–378PubMedCrossRefGoogle Scholar
  45. Osmers R, Völksen M, Rath W, Teichmann A, Kuhn W (1989) Vaginosonographische Messungen des postmenopausalen Endometrium zur Früherkennung des Endometriumkarzinoms. Geburtshilfe Frauenheilkd 49:262–265PubMedCrossRefGoogle Scholar
  46. Phillip H, Dacosta V, Fletcher H, Kulkarni S, Reid M (2004) Correlation between transvaginal ultrasound measured endometrial thickness and histophathological findings in Afro-Caribbean women with post-menopausal bleeding. J Obstet Gynaecol 24(5)568–572PubMedCrossRefGoogle Scholar
  47. Post MS, Van der Mooren MJ, Van Baal WM, Neele SJ et al. (2001) Raloxifen reduces impedance of flow within the uterine artery in early postmenopausal women: a year randomized, placebo-controlled, comparative study. Am J. Obstet Gynecol 185(3)557–562PubMedCrossRefGoogle Scholar
  48. Sawicki V, Spiewankiewicz B, Stelmachow J, Cendrowski K (2005) Color Doppler assessment of blood flow in endometrial cancer. Eur J Gynaecol Oncol 26(3):279–284PubMedGoogle Scholar
  49. Schwarzler P, Holden D, Nielsen S, Hahlin M, Sladkevicius P, Bourne TH (1999) The conservative management of first trimester miscarriages and the use of colour Doppler sonography for patient selection. Hum Reprod 14(5):1341–1345PubMedCrossRefGoogle Scholar
  50. Sieroszewski P, Suzin J, Bernaschek G, Deutinger J (2001) Evaluation of first trimester pregnancy in cases of threatened abortion by means of doppler sonography. Ultraschall Med 22(5):208–212PubMedCrossRefGoogle Scholar
  51. Sladkevicius P, Valentin L, Marsal K (1994) Endometrial thickness and Doppler velocimetry of the uterine arteries as discriminator of endometrial status in women with postmenopausal bleeding: A comparative study. Am J Obstet Gynecol 171:722–728PubMedGoogle Scholar
  52. Sladkevicius P, Valentin L, Marsal K (1995) Transvaginal Doppler examination for the differential diagnosis of solid pelvic tumors. J Ultrasound Med 14:377–380PubMedGoogle Scholar
  53. Szabo I, Szantho A, Csabay L, Csapo Z, Szirmai K, Papp Z (2002) Color Doppler ultrasonography in the differentiation of uterine sarcomas from uterine leiomyomas. Eur J Gynaecol Oncol 23(1): 29–34PubMedGoogle Scholar
  54. Tekay A, Jouppila P (1992) Color doppler flow as an indicator of trophoblastic activity in tubal pregnancies detected by transvaginal ultrasound. Obstet Gynecol 80:995–999PubMedGoogle Scholar
  55. Testa AC, Ferrandina G, Distefano M, Fruscella E, Mansueto D et al. (2004) Color Doppler velocimetry and three-dimensional color power angiography of cervical carcinoma Ultrasound Obstet Gynecol 24(4):445–452PubMedCrossRefGoogle Scholar
  56. Van Den Bosch T, Van Schoubroeck D, Lu C, De Brabanter J, Van Huffel S, Timmerman D (2002) Color Doppler and gray-scale ultrasound evaluation of the postpartum uterus. Ultrasound Obstet Gynecol 20(6)586–591PubMedCrossRefGoogle Scholar
  57. Weber G, Merz E, Bahlmann F, Rosch B (1998) Evaluation of different transvaginal sonographic diagnostic parameters in women with postmenopausal bleeding. Ultrasound Obstet Gynecol 12(4):265–270PubMedCrossRefGoogle Scholar
  58. Wherry KL, Dubinsky TJ, Waitches GM, Richardson ML, Reed S (2001) Low-resistance endometrial arterial flow in the exclusion of ectopic pregnancy revisited. J Ultrasound Med 20(4):335–342PubMedGoogle Scholar
  59. Wu YC, Yuan CC, Hung JH, Chao KC, Yen MS, NG HT (2000) Power Doppler angiographic appearance and blood flow velocity waveforms in invasive cervical carcinoma. Gynecologic Oncology 79(2):181–186PubMedCrossRefGoogle Scholar
  60. Zhou Q, Lei XY, Xie Q, Cardoza JD (2005) Sonographic and Doppler imaging in the diagnosis and treatment of gestational trophoblastic disease: a 12-year experience. J Ultrasound Med 24(1):15–24PubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag Heidelberg 2008

Authors and Affiliations

  • G. Bogner
    • 1
  • R. Gruber
    • 2
  1. 1.Klinikum Kreuzschwestern Wels Abt.für Gynäkologie und GeburtshilfeWelsÖsterreich
  2. 2.Universitätsklinik für Frauen-heilkunde und GeburtshilfeSalzburgÖsterreich

Personalised recommendations