TY - JOUR
T1 - Gray-scale and color Doppler sonographic features of the vaginal cuff and cervical remnant after hysterectomy
AU - Stein, Marjorie W.
AU - Grishina, Alla
AU - Shaw, Robert J.
AU - Roberts, Jeffrey H.
AU - Ricci, Zina J.
AU - Adachi, Akinori
AU - Freeman, Katherine
AU - Koenigsberg, Mordecai
PY - 2006/11
Y1 - 2006/11
N2 - OBJECTIVE. The purpose of this study was to define the sonographic characteristics of the vaginal cuff and cervical remnant after hysterectomy and to establish normal measurements of each after each type of surgery. MATERIALS AND METHODS. One hundred twenty-one women who had undergone hysterectomy (mean age, 51 years; range, 31-80 years) were studied using transabdominal or transvaginal sonography. Seventy-six patients were acquired retrospectively and 45 prospectively. Hysterectomy types included abdominal, 52% (63/121); supracervical, 17% (20/121); vaginal, 17% (20/121); and unknown, 15% (18/121). Two reviewers, who were blinded to clinical information, evaluated each cuff or remnant in consensus. Transabdominal anteroposterior, transvaginal anteroposterior, and transvaginal length measurements before and after transducer compression, and amount of color Doppler flow as shown by percentage of color pixels (n = 36 patients) were correlated with hysterectomy type and patient age. RESULTS. Supracervical cuffs were larger (p < 0.01) than abdominal and vaginal hysterectomy cuffs (transabdominal sonography anteroposterior, 2.8 vs 1.5 and 1.6 cm; transvaginal sonography anteroposterior, 3.3 vs 1.8 and 1.7 cm; and transvaginal length, 3.0 vs 2.1 and 1.9 cm). Anteroposterior measurements, but not length, decreased significantly with advancing age. Transvaginal length decreased with compression (mean, 0.84 cm; p < 0.0001). Color Doppler flow scores (minimum, 56% [20/36]; mild, 28% [10/36]; moderate, 14% [5/36]; and absent, 3% [1/36]) did not vary with age, time since surgery, or type of surgery. CONCLUSION. The remnant is larger in every dimension after supracervical hysterectomy compared with both abdominal and vaginal hysterectomy and commonly shows some color Doppler flow.
AB - OBJECTIVE. The purpose of this study was to define the sonographic characteristics of the vaginal cuff and cervical remnant after hysterectomy and to establish normal measurements of each after each type of surgery. MATERIALS AND METHODS. One hundred twenty-one women who had undergone hysterectomy (mean age, 51 years; range, 31-80 years) were studied using transabdominal or transvaginal sonography. Seventy-six patients were acquired retrospectively and 45 prospectively. Hysterectomy types included abdominal, 52% (63/121); supracervical, 17% (20/121); vaginal, 17% (20/121); and unknown, 15% (18/121). Two reviewers, who were blinded to clinical information, evaluated each cuff or remnant in consensus. Transabdominal anteroposterior, transvaginal anteroposterior, and transvaginal length measurements before and after transducer compression, and amount of color Doppler flow as shown by percentage of color pixels (n = 36 patients) were correlated with hysterectomy type and patient age. RESULTS. Supracervical cuffs were larger (p < 0.01) than abdominal and vaginal hysterectomy cuffs (transabdominal sonography anteroposterior, 2.8 vs 1.5 and 1.6 cm; transvaginal sonography anteroposterior, 3.3 vs 1.8 and 1.7 cm; and transvaginal length, 3.0 vs 2.1 and 1.9 cm). Anteroposterior measurements, but not length, decreased significantly with advancing age. Transvaginal length decreased with compression (mean, 0.84 cm; p < 0.0001). Color Doppler flow scores (minimum, 56% [20/36]; mild, 28% [10/36]; moderate, 14% [5/36]; and absent, 3% [1/36]) did not vary with age, time since surgery, or type of surgery. CONCLUSION. The remnant is larger in every dimension after supracervical hysterectomy compared with both abdominal and vaginal hysterectomy and commonly shows some color Doppler flow.
KW - Cervical remnant
KW - Color Doppler sonography
KW - Gray-scale sonography
KW - Gynecological imaging
KW - Hysterectomy
KW - Pelvic imaging
KW - Vaginal cuff
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U2 - 10.2214/AJR.05.0453
DO - 10.2214/AJR.05.0453
M3 - Review article
C2 - 17056931
AN - SCOPUS:33750315257
SN - 0361-803X
VL - 187
SP - 1372
EP - 1376
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 5
ER -