Purpose: The aim of this work was to review the technical aspects and clinical applications in our daily practice of three- (3D) and four-dimensional (4D) ultrasonography (US) in gynecologic imaging.
Material and methods: we used three different techniques to obtain 3D and 4D US images: freehand technique with a transvaginal (TV) approach, mechanical and matrix technique with transabdominal (TA) approach. We reviewed our own clinical experience of 159 patients in several clinical situations over the past 3 years.
Results: In most situations, volume US adds high diagnostic value to standard two-dimensional (2D) US. In particular, volume US is very helpful in the assessment of uterine malformations, in performing sonohysterography, in detecting the origin of adnexal lesions and in the guidance of interventional procedures, including abscess drainage in pelvis and abdomen. 3D US also provides accurate measurements in 3 planes with acceptable interobserver reliability, even in post-processing elaboration.
Conclusions: 3D US has proved to be a useful imaging tool for clinical problem solving in gynecology, especially in imaging the uterus and uterine cavity. However, it remains difficult to compare 2D and 3D because 2D imaging always precedes the 3D volume acquisition.