MULTIPLANAR AND THREE-DIMENSIONAL ULTRASOUND
IN GYNAECOLOGY - THE OVARY

The use of 3D ultrasound to study the ovary is still under examination. Feichtinger used 3D in infertile patients who had undergone ovarian stimulation to evaluate the volume of single cavity follicles. An indirect measurement of the volume was made; consequently, the follicle was aspirated and the actual volume of the follicular liquid was calculated.
Following are the details of the three scans needed for the examination of an ovary:

• To evaluate the correct position of the neighboring pelvic structure; in our experience this option is very useful to evaluate structures compatible with paraovarian cysts. (see fig.)
• Using the voxel point in multiplanar comparisons, to see any point of the ovary on three multiplanar scans at the same time. This option is particularly useful to study the ovarian mass, the structure of which, whether solid, multiloculated or complex, may be examined even with scans not available in B mode.
• Using 3D power, which allows to map the vessels of the neo-formation; this technique still presents some technical limitations related to the time of acquisition of the image, although the introduction of new digital vaginal ultrasound and the new MT software seems to have overcome this problem.

It is possible to obtain a power 3D rendering of the ovarian mass vessels: This option seems to be useful to evaluate neoplastic ovarian masses (Kurijak A., Kupesic S. et al. 1999)

Fig. 1 Trans-abdominal volume examined by MP rendering. Policystic ovarian disease (PCOD).

Fig. 2 Transabdominal volume. MP rendering. Para-ovarian cysts.

Fig. 3 Same case as in previous figure and same volume. Magnification.

Fig. 04a Trans-abdominal volume. The patient was underwent to ovarian stimulation for IVF-ET. The ovary is measured.

Fig. 04b Same case as the previous figure. Measurement of volume of a single follicle.

Fig. 5 Trans-abdominal volume. Power-Doppler examination: negative. Ovarian mass: borderline ovarian cysts.

Fig. 6 Transabdominal volume: power-Doppler examination. The principal septum was negative to power-Doppler examination (thickness of 15mm).

Fig. 7 Transabdominal volume. Multi-loculata ovarian mass with numerous septum (thickness over 3-4 mm): ovarian cancer.