3D AND 4D SONOGRAPHY IN OBSTETRICS AND GYNECOLOGY AS AN ADDITIONAL METHOD TO 2D EUCHOGRAPHY IN CASE SOLUTION

Abstract

The development of modern medicine and the introduction of technologies in the diagnosis and treatment
of patients determines the relevance of the application of 3D and 4D ultrasound in obstetrics and gynecology, as a
primary or additional diagnostic tool. In practice, ultrasound is now a routine part of every examination. Thanks to
it, normal physiological changes during the menstrual cycle can be evaluated (for example, ovulation and changes in
the thickness of the uterine lining during infertility research), to see abnormalities and tumors of the uterus and
ovaries, to guess with a high degree of probability whether a tumor is benign or malignant, to establish pregnancy,
as well as the location and (inside or outside the uterus) and to follow the development of the fetus throughout
pregnancy, looking for developmental deviations or the presence of malformations. Objective: To investigate the
development of sonoechography in the field of gynecology and to present the application of 3D/4D ultrasound
examination as an additional diagnostic method to 2D ultrasound when solving casuistic cases. Research material
and methods: Using a computer database, articles on three-dimensional and four-dimensional ultrasound diagnostics
in obstetrics and gynecology were reviewed. An analysis of the literature sources and a comparison with the
accumulated clinical experience over a period of 15 years has been made, the effectiveness in diagnosing
pathological findings in the area of the small pelvis through the application of 3D and 4D sonography has been
proven. Results and discussion: 3D and 4D sonography is a specialized ultrasound examination of the pelvic organs
for the diagnosis of congenital anomalies of the uterus (bicornuate, unicornuate, double, septate uterus, etc.), polyps,
submucous fibroids, uterine fibroids, endometriosis, adenomyosis , ovarian cysts, etc. Screening and diagnosis of
neoplasia of the uterus and ovaries, folliculometry (ultrasound monitoring of the ovarian cycle in sterility and
infertility), diagnosis of ectopic pregnancy and molar pregnancy. The main advantage of transvaginal 3D/4D
ultrasonography is the ability to generate cross-sections of the pelvis in addition to conventional sagittal and coronal
planes. This makes it possible not only to determine the maximum size of an abnormal object, but also to define the
exact location of the lesion in all three planes. The ability to visualize all three orthogonal planes simultaneously on
the monitor also allows for accurate volumetric analysis. This is important in determining tumor volume. In
reproductive medicine, hysterocontrast sonography is used, which is the main procedure for evaluating the uterine
cavity and fallopian tubes. 3D ultrasound can also be used to obtain an image of a normal and abnormal pelvic floor.
Conclusion: Pelvic scanning with a transvaginal 3D/4D probe opens up new diagnostic possibilities. Using 3D for
gynecological applications requires an additional investment of time.