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Application of three-dimensional ultrasonography in the differentiation of Mullerian duct anomalies

dc.contributor.advisorDimitrijević, Aleksandra
dc.contributor.otherVarjačić, Mirjana
dc.contributor.otherĐurić, Janko
dc.contributor.otherMitrović-Jovanović, Ana
dc.creatorZoričić, Davor
dc.date.accessioned2020-07-06T15:44:52Z
dc.date.available2020-02-26T15:44:52Z
dc.date.available2020-07-03T15:20:39Z
dc.date.issued2020-01-28
dc.identifier.urihttp://eteze.kg.ac.rs/application/showtheses?thesesId=7188
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/12013
dc.identifier.urihttps://fedorakg.kg.ac.rs/fedora/get/o:1222/bdef:Content/download
dc.description.abstractSAŽETAK: Cilj. Ova je studija imala za cilj utvrditi mogućnosti otkrivanja i diferencijacije uterinih anomalija Müllerova tipa na koronalnom presjeku maternice dobivenom pomoću trodimenzionalnog transvaginalnog ultrazvuka. Dizajn studije. Ovo prospektivno, nerandomizirano istraživanje obuhvatilo je dvije skupine žena u reproduktivnoj dobi, 114 pacijentica klinike za liječenje infertiliteta i 196 ispitanica neselektirane populacije. Dvije su skupine pacijentica uspoređivane prema dimenzijama uterusa i pojavnosti anomalija. Svakoj je pacijentici pomoću trodimenzionalne transvaginalne sonografije načinjen koronalni presjek maternice na kojemu su izmjerene sljedeće dimenzije: dužina šupljine maternice od unutrašnjeg cervikalnog ušća do fundusa, razmak između tubarnih ušća, debljina fundalnog miometrija, fundalna i lateralna indentacija šupljine maternice te omjer dužina trupa i vrata maternice. Određivanje i klasifikacija anomalija maternice učinjeno je na osnovi ESHRE/ESGE klasifikacije. Rezultati. Ukupno je nađeno 25 ispitanica (8%) s anomalijama maternice Müllerova tipa. U grupi neselektiranih pacijentica otkriveno je 9 (4,6%) anomalija, a u skupini subfertilnih pacijentica 16 (14,4%), što je trostruko veća pojavnost (p<0,001). U obje skupine najčešće su anomalije iz skupine dismorfnih uterusa (U1) i parcijalnih septuma (U2a) koje ukupno čine 69% svih anomalija. Nisu opažene značajne razlike u pojavnosti blagog arkuatnog oblika fundusa šupljine maternice (unutrašnja indentacija 10 do 20% interostijalnog razmaka) kod subfertilnih pacijentica u odnosu na opću populaciju. U skupini infertilnih pacijentica zabilježena je manja udaljenosti od unutrašnjeg ušća do fundusa (p<0,01) i veća dubina fundalnog indentacije (p<0,05) nego u ispitanica neselektirane populacije, dok u pogledu interostalnog razmaka i debljine fundalnog miometrija nisu primijećene razlike. Utvrđeno je da pluripare imaju veću debljinu fundalnog miometrija, dužu šupljinu maternice i jače izraženu fundalnu i lateralnu indentaciju u odnosu na nulipare, međutim nisu opažene značajnije razlike u interostijalnoj udaljenosti i odnosu duljine trupa i vrata maternice.sr
dc.description.abstractABSTRACT: Purpose To evaluate the possibility of detection and differentiation of Müllerian uterine anomalies on the basis of coronal plane obtained by three-dimensional transvaginal ultrasonography Materials and Methods This prospective nonrandomized study enrolled 310 non-pregnant women who underwent three-dimensional ultrasound examination. The patients were divided into two groups: subfertile and unselected women and were compared by the prevalence of congenital uterine malformations. Each examination was followed by the reconstructed three-dimensional images in the coronal plan with visualization of both fallopian tube ostia and internal cervical os. Several measurements were taken from the reconstructed picture of uterus: the length of the uterine cavity as a distance from the level of the internal os to the fundus, distance between the two internal tubal ostia, fundal wall thickness, thickness of fundal concavity in relation to interostial line resulting in depth of fundal cavity indentation, lateral wall indentation and uterine corpus/cervix ratio. Uterine malformations were classified on the basis of the ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Results We diagnosed Müllerian duct anomalies in 25 patients (8%). In the group of subfertile patients the number of assessed anomalies was significantly higher (16; 14.4%) as compared to the unselected patients (9; 4.6%). The most common anomalies in both groups were those from the Class U1 or dysmorphic uterus and partially septate uterus. Although the prevalence of uterine anomalies was increased in the infertile patients, there was no difference in the prevalence of uterus with mild arcuate appearance between the groups. In the group of subfertile patients the length of uterine cavity was decrease as compared to the unselected women. This difference was also visible in the case of nulliparous women from both groups. On the other hand, the thickness of fundal myometrium, the distance between the two internal tubal ostia and corpus to cervix ratio did not vary among patients. It was found that pluripers have a greater thickness of the fundal myometrium, longer uterine cavity lenght and stronger pronounced fundal and lateral indentations of uterine cavity than nulliparous, but significant differences in the distance between internal tubal ostia and corpus to cervix ratio were not observed.en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Крагујевцу, Факултет медицинских наукаsr
dc.rightsopenAccessen
dc.sourceУниверзитет у Крагујевцуsr
dc.subjecttrodimenzionalni transvaginalni ultrazvuk, anomalije Müllerovih kanala, ESHRE/ESGE klasifikacija uterinih anomalijasr
dc.subjectThree-dimensional ultrasound imaging, coronal plane, congenital uterine malformationsen
dc.titlePrimena trodimenzionalnog ultrazvuka u diferencijaciji anomalija maternice Mulerovog tipasr
dc.title.alternativeApplication of three-dimensional ultrasonography in the differentiation of Mullerian duct anomaliesen
dc.typedoctoralThesis
dc.rights.licenseBY-NC
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/50288/Disertacija.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/50289/Davor_Zoricic_Medicinski.pdf


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