Transperineal Vulvar Ultrasound: A Review of Normal and Abnormal Findings with a Proposed Standardized Methodology.

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Diagnostics Pub Date : 2025-03-05 DOI:10.3390/diagnostics15050627
Nina Montik, Camilla Grelloni, Giovanni Delli Carpini, Jessica Petrucci, Jacopo Di Giuseppe, Andrea Ciavattini
{"title":"Transperineal Vulvar Ultrasound: A Review of Normal and Abnormal Findings with a Proposed Standardized Methodology.","authors":"Nina Montik, Camilla Grelloni, Giovanni Delli Carpini, Jessica Petrucci, Jacopo Di Giuseppe, Andrea Ciavattini","doi":"10.3390/diagnostics15050627","DOIUrl":null,"url":null,"abstract":"<p><p>The vulva is a complex anatomical organ that may present with a wide range of pathologies. Even if it can be easily investigated, correctly interpreting vulvar appearance is often challenging. Vulvar ultrasound is an emerging diagnostic technique that may be helpful in different aspects of vulvar pathology. We aimed to summarize the state of the art of vulvar ultrasound, provide the necessary theoretical bases of embryology and anatomy, describe the normal and pathological vulvar sonographic characteristics, and propose a feasible and reproducible methodology for vulvar ultrasound. Vulvar sonographic scan should be performed with a linear probe, preferably > 15 mHz, following a standardized methodology. The sonographic appearance of the normal vulva reflects the different histology of its structures and, thus, their embryogenetic origin. The description of a suspected vulvar lesion should include localization, dimensions, volume, type of growth, shape, appearance of the edges, depth of invasion, echogenicity, and identification of vascularization. Cystic dilatation of obstructed Bartolini ducts is the most common benign finding in the vulva (fluctuant structures in the posterior third of the labia majora containing clear mucous fluid). Malignant vulvar lesions appear as hypoechogenic or heterogeneous solid lesions with irregular margins and a high degree of vascularization. Extramammary Paget Disease presents a homogeneous hypoechogenic creeping area in the epidermis due to neoplastic cells typical of this disease. The potential applications of vulvar ultrasound are examining the content of a vulvar swelling to guide its management and assessing the response to medical treatment in the case of lichen sclerosus. In managing patients affected by vulvar malignancies, it may play a critical role in local staging, stromal invasion determination, measuring the distance from the midline, and assessing the eligibility for sentinel lymph node procedure. Vulvar ultrasound is a minimally invasive and economical test that can be performed with minimal equipment. Further studies will be necessary to validate the clinical applications, quantify the diagnostic performance, and evaluate the agreement between operators.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 5","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899668/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/diagnostics15050627","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

The vulva is a complex anatomical organ that may present with a wide range of pathologies. Even if it can be easily investigated, correctly interpreting vulvar appearance is often challenging. Vulvar ultrasound is an emerging diagnostic technique that may be helpful in different aspects of vulvar pathology. We aimed to summarize the state of the art of vulvar ultrasound, provide the necessary theoretical bases of embryology and anatomy, describe the normal and pathological vulvar sonographic characteristics, and propose a feasible and reproducible methodology for vulvar ultrasound. Vulvar sonographic scan should be performed with a linear probe, preferably > 15 mHz, following a standardized methodology. The sonographic appearance of the normal vulva reflects the different histology of its structures and, thus, their embryogenetic origin. The description of a suspected vulvar lesion should include localization, dimensions, volume, type of growth, shape, appearance of the edges, depth of invasion, echogenicity, and identification of vascularization. Cystic dilatation of obstructed Bartolini ducts is the most common benign finding in the vulva (fluctuant structures in the posterior third of the labia majora containing clear mucous fluid). Malignant vulvar lesions appear as hypoechogenic or heterogeneous solid lesions with irregular margins and a high degree of vascularization. Extramammary Paget Disease presents a homogeneous hypoechogenic creeping area in the epidermis due to neoplastic cells typical of this disease. The potential applications of vulvar ultrasound are examining the content of a vulvar swelling to guide its management and assessing the response to medical treatment in the case of lichen sclerosus. In managing patients affected by vulvar malignancies, it may play a critical role in local staging, stromal invasion determination, measuring the distance from the midline, and assessing the eligibility for sentinel lymph node procedure. Vulvar ultrasound is a minimally invasive and economical test that can be performed with minimal equipment. Further studies will be necessary to validate the clinical applications, quantify the diagnostic performance, and evaluate the agreement between operators.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
外阴是一个复杂的解剖器官,可能会出现各种病变。即使很容易进行检查,正确解释外阴外观也往往具有挑战性。外阴超声是一种新兴的诊断技术,可能对外阴病理的不同方面有所帮助。我们旨在总结外阴超声的最新进展,提供必要的胚胎学和解剖学理论基础,描述正常和病理外阴超声特征,并提出可行且可重复的外阴超声检查方法。外阴超声扫描应使用线性探头,最好大于 15 mHz,并遵循标准化方法。正常外阴的声像图外观反映了其结构的不同组织学,因此也反映了其胚胎起源。对可疑外阴病变的描述应包括病变的位置、尺寸、体积、生长类型、形状、边缘外观、侵犯深度、回声性和血管的识别。外阴最常见的良性病变是阻塞的巴托里尼管囊性扩张(大阴唇后三分之一处的波动结构,内含透明粘液)。恶性外阴病变表现为低水肿或异型实变,边缘不规则,有高度血管化。乳腺外 Paget 病由于典型的肿瘤细胞,表皮会出现均匀的低糜烂性匍匐区。外阴超声的潜在应用包括检查外阴肿物的内容以指导治疗,以及评估苔藓硬化症患者对药物治疗的反应。在治疗外阴恶性肿瘤患者时,外阴超声可在局部分期、确定基质侵犯、测量与中线的距离以及评估前哨淋巴结手术的资格等方面发挥关键作用。外阴超声是一种微创、经济的检查方法,只需少量设备即可进行。有必要开展进一步的研究,以验证临床应用、量化诊断性能并评估操作者之间的一致性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
期刊最新文献
The Value of Clinical Decision Support in Healthcare: A Focus on Screening and Early Detection. Pain-Related White-Matter Changes Following Mild Traumatic Brain Injury: A Longitudinal Diffusion Tensor Imaging Pilot Study. Performance Comparison of Two In-House PCR Methods for Detecting Neisseria meningitidis in Asymptomatic Carriers and Antimicrobial Resistance Profiling. Fine-Tuned Machine Learning Classifiers for Diagnosing Parkinson's Disease Using Vocal Characteristics: A Comparative Analysis. Comparing ChatGPT 4.0's Performance in Interpreting Thyroid Nodule Ultrasound Reports Using ACR-TI-RADS 2017: Analysis Across Different Levels of Ultrasound User Experience.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1