scholarly journals Multioperator Algorithm-Based Ultrasound Imaging Combined with Hysteroscopy for the Diagnosis of Endometrial Polyps

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yousheng Li ◽  
Guitao Xia

This study aimed to explore the diagnosis of endometrial polyps (EMP) by ultrasound imaging based on multi-operator algorithms combined with hysteroscopy. This study is the first to investigate the resolution of the ultrasound adaptive beamforming algorithm (MOAD), after which the proposed algorithm was applied to ultrasound diagnosis of 102 patients with EMP and pathologically diagnosed with vaginal irregular bleeding, and the evaluation efficacy of the MOAD algorithm based on EMP was compared. The resolution of the MOAD-based imaging algorithm (0.0645) was significantly lower than that of the diagonal loading operator (0.1475), the symbol coherence coefficient operator (0.1342), and the generalized coherence factor operator (0.1234), with significant differences ( P < 0.05 ). The proportion of patients with EMP aged 46–55 years was the largest (55.9%). There were 64 cases of EMP that produced complications, of which the proportion of patients with uterine fibroids (41.52%), abnormal uterine bleeding (76.24%), and menstrual changes (42.57%) was relatively large. Patients with nonfunctioning polyps accounted for the largest proportion (84.46%), followed by those with basal polyps (76.24%), and the difference was statistically significant ( P < 0.05 ). The positive cases of EMP detected by ultrasound imaging (38 cases) were significantly lower than those with pathological diagnosis (94 cases), and the difference was statistically significant ( P < 0.05 ). The SE, SP, FNR, and FPR of EMP diagnosed by ultrasound imaging combined with hysteroscopy were 64.45%, 84.67%, 35.48%, and 13.36%, respectively. It has high diagnostic value compared with single ultrasound imaging diagnosis, and the difference was statistically significant ( P < 0.05 ). In conclusion, the imaging based on the MOAD algorithm is obvious and the pixel resolution can be successfully improved. The diagnostic value of ultrasound combined with hysteroscopy for EMP was better than that of ultrasound alone ( P < 0.05 ), and it had a high diagnostic value.

Author(s):  
Nicole Sequeira ◽  
Shannon Fernandes

Background: AUB is a commonly encountered complaint in peri- and postmenopausal women visiting OBG OPDs and accounts for about 70% of all gynaecological complaints. Key to management depends on the cause of AUB. Protocol has changed over the years from performing investigations randomly to a condition specific approach. This study aims to evaluate and compare the efficacy of transvaginal sonography and hysteroscopy in perimenopausal women with AUB and note its relation with histopathology.Methods: A prospective study was conducted on 103 women of 40-55 years presenting to the OBG OPD of Father Muller Medical College Hospital, Mangalore. All patients underwent a transvaginal scan to note the endometrial thickness followed by a hysteroscopy and biopsy. Endometrium was sent for histopathology. Findings of these modalities were correlated.Results: The diagnostic value of transvaginal sonography in relation to histopathology had a sensitivity and specificity of 33.33% and 95.95% for atrophic endometrium, 52.5% and 62.9% for proliferative, 29.41% and 79.41% for secretory, and 55.55% and 74.19% for hyperplastic. When compared to histopathology, hysteroscopy had a sensitivity and specificity of 100% and 92.3% for atrophic, 26.19% and 96.96% for proliferative, 27.07% and 98.59% for secretory, and 100% and 64.94% for hyperplastic endometrium. It had a sensitivity of 77.77% and a specificity of 92.92% for endometrial polyps. Agreement between TVS and histopathology based on kappa co-efficient was fair for atrophic endometrium but poor for proliferative, secretory and hyperplastic endometrium. Agreement between hysteroscopy and histopathology was moderate for atrophic endometrium and for endometrial polyps. It was fair for proliferative, secretory and hyperplastic endometrium.Conclusions: TVS seems to be a good initial method for evaluation of AUB. However, a subsequent hysteroscopy with biopsy is advisable to evaluate the cause of AUB.


2008 ◽  
Vol 36 (6) ◽  
pp. 1205-1213 ◽  
Author(s):  
B Yildizhan ◽  
R Yildizhan ◽  
B Ozkesici ◽  
N Suer

This prospective study investigated 79 pre- and 25 post-menopausal women with abnormal uterine bleeding who underwent conventional transvaginal ultrasonography (TVS) and saline infusion sonohysterography (SIS) and compared the results with histopathological findings obtained by dilatation and curettage, hysteroscopy or hysterectomy. Histological examination revealed normal endometrial histology in 28 patients, intracavitary polyps in 46 patients, submucosal fibroids in 18 patients, intramural fibroids in six patients and endometrial hyperplasia in six patients. The sensitivity and specificity of TVS in detecting endometrial polyps were 65.2% and 87.9%, respectively, compared with 91.3% and 93.1% for SIS. The sensitivity and specificity of TVS in detecting uterine fibroids were 95.8% and 95.0%, respectively, versus 91.6% and 98.7% for SIS. These results show that SIS is a satisfactory method of identifying lesions and that it is easy and cost-effective, and improves on the diagnostic utility of TVS. SIS is also a less invasive alternative to hysteroscopy, so should result in less morbidity in the evaluation of abnormal uterine bleeding in women.


Author(s):  
John P. Langmore ◽  
Brian D. Athey

Although electron diffraction indicates better than 0.3nm preservation of biological structure in vitreous ice, the imaging of molecules in ice is limited by low contrast. Thus, low-dose images of frozen-hydrated molecules have significantly more noise than images of air-dried or negatively-stained molecules. We have addressed the question of the origins of this loss of contrast. One unavoidable effect is the reduction in scattering contrast between a molecule and the background. In effect, the difference in scattering power between a molecule and its background is 2-5 times less in a layer of ice than in vacuum or negative stain. A second, previously unrecognized, effect is the large, incoherent background of inelastic scattering from the ice. This background reduces both scattering and phase contrast by an additional factor of about 3, as shown in this paper. We have used energy filtration on the Zeiss EM902 in order to eliminate this second effect, and also increase scattering contrast in bright-field and dark-field.


2018 ◽  
Vol 2 (5) ◽  
pp. 744
Author(s):  
Zainur Zainur

This research was motivated by the low learning outcomes of grade IX SMP Muhammadiyah Padang LuasKecamatan Tambang Kabupaten Kampar. This study aims to improve learning outcomes in mathematicslearning through STAD type cooperative learning with the RME approach in class IX SMP MuhammadiyahPadang Luas Kecamatan Tambang Kabupaten Kampar. The subjects of this study were all classes IX in SMPMuhammadiyah Padang Luas Kecamatan Tambang Kabupaten Kampar totaling 26 people. The form ofresearch is classroom action research. This research instrument consists of performance instruments and datacollection instruments in the form of teacher activity observation sheets and activities. The results of the studystated that there were significant differences between students' mathematics learning outcomes before applyingthe STAD type cooperative learning model with the RME approach with after applying the STAD typecooperative learning model with the RME approach. The difference shows student learning outcomes after theaction is better than before the action with completeness reaching 80.77% or 21 completed. Based on the resultsof the study and discussion it can be concluded that the application of STAD type learning model with RealisticMathematic Education (RME) approach can improve the learning outcomes of grade IX students of SMPMuhammadiyah Padang Luas Kecamatan Tambang Kabupaten Kampar on statistical material.


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Bosco ◽  
S Gambelli ◽  
V Urbano ◽  
G Cevenini ◽  
G Messina

Abstract Background Sanitizing the operating theatres (OT) is important to minimize risk of post-operative infections. Disinfection procedures between one operation and another is less aggressive than final cleaning procedures, at the end of the day. Aim was assessing the difference of contamination: i) between different levels of disinfection; ii) before and after the use of a UVC Device (UVC-D). Methods Between December 2019/February 2020 a cross sectional study was conducted in OT in a real clinical context. 94 Petri dishes (PD) were used in 3 OT. Three different sanitation levels (SL1-3) were compared pre- and post-use of UVC-D: i) No cleaning after surgery (SL1); ii) after in-between cleaning (SL2); iii) after terminal cleaning (SL3). UVC-D was employed for 6 minutes, 3 minutes per bed side. PD were incubated at 36 °C and colony forming unit (CFU) counted at 48h. Descriptive statistic, Wilcoxon and Mann-Whitney tests were performed to assess the contamination levels in total, pre/post use of UVC-D, and between different sanitation levels, respectively. Results In total we had a mean of 3.39 CFU/PD (C.I. 2.05 - 4.74) and a median of 1 CFU/PD (Min. 0 - Max. 39), after UVC-D use we had a mean of 2.20 CFU/PD (C.I. 0.69 - 5.09) and a median of 0 CFU/PD (Min. 0 - Max. 133). The UVC-D led to a significant reduction of CFU (p &lt; 0.001). Without UVC-D we had a significant CFU drop (p &lt; 0.05) between SL1 and SL3. Using UVC-D, we observed significant reductions of contamination (p &lt; 0.05) between SL3 and SL1. Comparing SL1 (median 0) post UVC-D use vs SL2 pre UVC-D use (median 0.5), and SL2 post UVC-D use (median 0) vs SL3 pre UVC-D use (median 1) we had a significant reduction of contamination (p &lt; 0.05). Conclusions UVC-D improved environmental contamination in any of the three sanitation levels. Furthermore, the use of UVC-D alone was better than in-between and terminal cleaning. Although these encouraging results, the cleaning procedures executed by dedicated staff has to be considered. Key messages UVC are efficient to decrease contamination in operating theatres regardless of sanitation levels. The additional use of UVC technology to standard cleaning procedures significantly improves sanitation levels.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
YunZheng Zhang ◽  
ZiHao Wang ◽  
Jin Zhang ◽  
CuiCui Wang ◽  
YuShan Wang ◽  
...  

Abstract Background Hysteroscopy is a commonly used technique for diagnosing endometrial lesions. It is essential to develop an objective model to aid clinicians in lesion diagnosis, as each type of lesion has a distinct treatment, and judgments of hysteroscopists are relatively subjective. This study constructs a convolutional neural network model that can automatically classify endometrial lesions using hysteroscopic images as input. Methods All histopathologically confirmed endometrial lesion images were obtained from the Shengjing Hospital of China Medical University, including endometrial hyperplasia without atypia, atypical hyperplasia, endometrial cancer, endometrial polyps, and submucous myomas. The study included 1851 images from 454 patients. After the images were preprocessed (histogram equalization, addition of noise, rotations, and flips), a training set of 6478 images was input into a tuned VGGNet-16 model; 250 images were used as the test set to evaluate the model’s performance. Thereafter, we compared the model’s results with the diagnosis of gynecologists. Results The overall accuracy of the VGGNet-16 model in classifying endometrial lesions is 80.8%. Its sensitivity to endometrial hyperplasia without atypia, atypical hyperplasia, endometrial cancer, endometrial polyp, and submucous myoma is 84.0%, 68.0%, 78.0%, 94.0%, and 80.0%, respectively; for these diagnoses, the model’s specificity is 92.5%, 95.5%, 96.5%, 95.0%, and 96.5%, respectively. When classifying lesions as benign or as premalignant/malignant, the VGGNet-16 model’s accuracy, sensitivity, and specificity are 90.8%, 83.0%, and 96.0%, respectively. The diagnostic performance of the VGGNet-16 model is slightly better than that of the three gynecologists in both classification tasks. With the aid of the model, the overall accuracy of the diagnosis of endometrial lesions by gynecologists can be improved. Conclusions The VGGNet-16 model performs well in classifying endometrial lesions from hysteroscopic images and can provide objective diagnostic evidence for hysteroscopists.


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