関谷 隆夫, 藤井 多久磨

Takao SEKIYA, Takuma FUJII

藤田保健衛生大学医学部産婦人科

Obstetrics and Gynecology, Fujita Health University

キーワード :

In obstetrical and gynecological practice, the ultrasound is utilized as representative clinical examination. Because, the real time imaging, handiness and the low invasiveness are the advantage for the diagnosis of internal sex organ with generative cells and fetuses.
Transabdominal and transvaginal scan had been usually accepted for the imaging of female internal genitalia, however, we could get only tow-dimensional single plane by manual scanning of a probe, and the direction of the viewpoint was limited, also.
In 1986，Baba and his colleagues developed the modern three-dimensional ultrasound system in obstetrics, and a live fetus in utero was depicted threedimensionally. Afterwards, the three-dimensional imaging of the female internal genitalia came to be carried out by medical engineering progress. The perpendicular three-dimensional and arbitrary section imaging and volume calculation of the organ and tumor was enabled by using this technique, furthermore, a three-dimensional form, distribution and intensity of the blood flow were realized by combining the Doppler ultrasound. In addition, Shinozuka and his colleagues manufactured transvaginal sonographic orientation detection system using ceramic gyroscopes as a tool for labeling of sonographic images, and it was put to practical use recently.
In the gynecological practice, uterus, ovary and fallopian tube are targeted for observation, and three-dimensional ultrasound are performed in the following occasions.
Uterus: morphological evaluation of uterine anomalies and intra uterine devices, localization and volume calculation of uterine tumors, morphological evaluation of intrauterine abnormalities under sonohysterography, morphological and quantitative evaluation of uterine blood flow
Ovary: volume calculation of ovarian tumors, localization and volume calculation of solid parts, antral follicle count and diachronic volume calculation of growing follicle, morphological and quantitative evaluation of ovarian blood flow
Fallopian tube: morphological evaluation of tubal patency under sonohysterosalpingography
Three-dimensional ultrasound for female internal genitalia should improve visibility and diagnosis precision, and is more useful as a tool of the information management and the real-time labeling. In this session, I will introduce the latest knowledge and the skill to acquire the gynecological ultrasound.