title: [Using contrast inversion to extend the diagnostic value of perineal ultrasound for urethral and paraurethral pathologies].
abstract: OBJECTIVE
  The aim of our study was to show how using contrast inversion extends the diagnostic value of perineal ultrasound, in particular with regard to paraurethral pathologies.
  
  
  METHODS
  To assess the practical value of contrast inversion in the daily routine, 42 women with urinary incontinence underwent perineal ultrasound examination. Pictures were converted to contrast inversion and then checked for the visibility of sonographic reference points for urogynecological measurements (urethra, meatus urethrae internus, vesical base) by two independent evaluators both in B-mode and contrast inversion. Visibility was compared using a coefficient of agreement. The results were then tested for significance. In addition, in our clinical routine we detected several paraurethral pathologies (e. g. paraurethral abscess, glandula paraurethralis, urethral diverticulum), each being presented in B-mode and contrast inversion.
  
  
  RESULTS
  There was no significant difference between contrast inversion and B-mode with regard to the reproducibility of visibility of the three sonographic reference points. Contrast inversion was superior for depicting paraurethral pathologies and postoperative anatomical findings.
  
  
  CONCLUSIONS
  With respect to routine evaluation, the two modes do not reveal any significant difference. For the sonographic evaluation of paraurethral pathologies, contrast inversion provides better contour sharpness than B-mode, suggesting a higher diagnostic value for ambiguous anatomical settings. The nature of contrast inversion nevertheless facilitates misinterpretations and requires frequent comparison with B-mode pictures. In conclusion, we propose contrast inversion as an initial screen and a refinement to established diagnostic methods, such as MRI and voiding cysturethrography, not as their substitute.
authors.affiliation: Frauenklinik für Gynäkologie und Geburtsmedizin, Universitätsklinikum RWTH Aachen, Aachen. lnajjari@ukaachen.de
authors.forename: L
authors.initials: L
authors.lastname: Najjari
authors.forename: R
authors.initials: R
authors.lastname: Blum
authors.forename: J
authors.initials: J
authors.lastname: Hennemann
authors.forename: N
authors.initials: N
authors.lastname: Maass
authors.forename: R
authors.initials: R
authors.lastname: Kirschner-Hermanns
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010502:Perineum / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*; D014521:Urethra / Q000000981:diagnostic imaging*; D014522:Urethral Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014549:Urinary Incontinence / Q000000981:diagnostic imaging* / Q000601:surgery; D014563:Urodynamics / Q000502:physiology; D014599:Uterus / Q000000981:diagnostic imaging; D014621:Vagina / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media