ROLE OF VCI –OMIVEIW (4D ULTRASOUND TECHNOLOGY) IN ACCURATE AND FAST DETECTION OF IUCD COMPLICATIONS

Hussein Montaser*, Ehab Elhelw and Alaa Ibrahim

ABSTRACT

Background & purposes: During 2D ultrasound exam of the pelvis we can suspect or partially detect abnormal position of the IUCD but we need a fast ,easy and an accurate technique to accurately diagnose such IUCD complications to deal with it, particularly if the exam was done without specific complain ( the most of our pateints are referred from the ER department, the most of the referred ER pateints have no symptoms related to IUCD), the 3D sonography has two disadvantages , the first one is that the exam is time consuming ( time to acquiring a volume of uterus and relatively long time for reconstructing the images through the multiplanar technique, allows visualization of the appropriate sagittal and coronal views),the second disadvantage is that the exam need the operator to be skilled in 3D orientation and subsequent retrieval of the diagnostic planes from acquired volumes. The aim of this work was to demonstrate the significant role of the VCI - omniview 4D application in an accurate and fast detection of IUCD complications and to decrease the requirement of skills from the operator as in the 3D sonography where the operator needs to choose the diagnostic planes from the acquired volume (i.e. omniview VCI technique is a fast and simple technique as compared to the 3D sonography with the same accuracy). Methods: This observational comparative study was done at al salam international Hospital between June 2013 to December 2016. 74 patients are diagnosed or suspected to have IUCD abnormalities by 2D ultrasound irrespective to their complain, they underwent complementary transabdominal or transvaginal 3D and 4D (3D volume acquisition of the uterus and Omiveiw VCI 3 and 4D technique). Results: In our study, 4 patients are diagnosed by 2D sonography with no more findings was detected by 3D and 4D sonography however the 3D or 4D omniview VCI sonography is mandatory to confirm the diagnosis and to exclude the presence of other findings, the remaining 70 patients are partially diagnosed or not diagnosed by 2D sonography and accurately diagnosed by other modalities , the same accuracy was obtained by the 3D sonography and the 4D omniveiw VCI sonography however the diagnosis by 3D sonography needs more time , more effort and more operator skills. Conclusion and Recommendations: The VCI - omniview 4D sonography is practically better than the 3D sonography in detection of IUCD complications inspite of the same accuracy of both techniques due to the VCI - omniview 4D sonography takes less time and less efforts for detection of the findings and also need less operator skills as compared to the 3D sonography.

Keywords: IUCD complications, 3D sonography, VCI - omniview 4D sonography.