usfdУльтразвуковая и функциональная диагностикаUltrasound & Functional Diagnostics1607-07712408-9494RDS-Media Ltd.usfd-398Research ArticleУльтразвуковая диагностика в акушерстве и гинекологииObstetrics and Gynecology UltrasoundОпределение факторов риска экспульсии левоноргестрел-рилизинг внутриматочной системы “Мирена” с помощью трехмерной трансвагинальной эхографииThree-Dimensional Ultrasound in Risk Assessment of Levonorgestrel-Releasing Intrauterine System (Mirena) ExpulsionТохунцК. А.TokhuntsK. A.tokhuntskarine@gmail.comХудавердянА. Д.KhudaverdyanA. D.ДжулакянК. С.JulhakyanK. S.АбгарянН. Б.AbgaryanN. B.Ереванский государственный медицинский университет имени Мхетара ГерациYerevan State Medical University after Mkhitar HeratsiЦентральный клинический военный госпиталь, г. ЕреванCentral Clinical Military Hospital, Yerevan201525032026025667Copyright © Тохунц К.А., Худавердян А.Д., Джулакян К.С., Абгарян Н.Б., 20262026Тохунц К.А., Худавердян А.Д., Джулакян К.С., Абгарян Н.Б.Tokhunts K.A., Khudaverdyan A.D., Julhakyan K.S., Abgaryan N.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://usfd.rdsmedia.ru/jour/article/view/398

Целью исследования явилась разработка трехмерных эхографических критериев прогнозирования экспульсии внутриматочного средства “Мирена” путем оценки формы и размеров полости матки при трехмерной реконструкции полости матки в коронарном сечении. В ретроспективное исследование включены 103 пациентки в возрасте от 28 до 52 лет, которым была введена система “Мирена” с целью лечения менометроррагий, рецидивирующей гиперплазии эндометрия и аденомиоза. Подгруппу I составили 86 пациенток, которым перед введением системы “Мирена” в обязательном порядке проведено трехмерное трансвагинальное ультразвуковое исследование с реконструкцией матки в коронарном сечении, подгруппу II - 17 пациенток с уже произошедшими экспульсиями, которым система “Мирена” была введена без предварительной трехмерной эхографии. Высокая частота экспульсий была сопряжена с деформациями полости матки (64,7% среди пациенток подгруппы II без данных предварительной трехмерной эхографии), шириной полости матки в области трубных углов в коронарном сечении при трехмерной реконструкции более 4,5 см (чувствительность в прогнозировании экспульсии 58%, специфичность - 98%), увеличением площади ее полости более 9,0 см2 (чувствительность в прогнозировании экспульсии 58%, специфичность - 98%).

Aim of the study was to find three-dimensional ultrasound criteria which could help to predict risk of levonorgestrel-releasing intrauterine system (Mirena) expulsion. Uterus cavity shape and size in coronal view were used as such criteria. 103 patients aged from 28 up to 52 years old who underwent treatment by Mirena due to menometrorrhagia, endometrial hyperplasia, and adenomyosis were included in to the study. First subgroup was formed by 86 patients who underwent mandatory three-dimensional transvaginal ultrasound with uterus coronal plane reconstruction before treatment by Mirena; second subgroup - by 17 patients with Mirena expulsion who did not undergo preliminary three-dimensional ultrasound. High frequency of expulsions was related to uterine cavity deformation (64.7% among second subgroup patients without preliminary three-dimensional ultrasound); increase of uterine cavity width on tubal orifices level in coronal view more than 4.5 cm (sensitivity of expulsion prediction 58%, specificity - 98%); increase of uterine cavity area more than 9.0 cm2 (sensitivity of expulsion prediction 58%, specificity - 98%).

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The authors declare that there are no conflicts of interest present.