Endocavitary three-dimensional ultrasonographic assistance for transvaginal or transrectal drainage of pelvic fluid collections.

PURPOSE: Determine the feasibility of using three-dimensional ultrasonography (3D US) to assist in planning and performing endocavitary drainage of deep pelvic fluid collections.

MATERIALS AND METHODS: Retrospective review of images and medical records of 16 patients in whom endocavitary 3D US was used during transvaginal or transrectal drainage of 17 deep fluid collections. 3D US was assessed regarding its ability to display the relevant structures, whether new information was provided compared with pelvic computed tomography (CT) and conventional two-dimensional US (2D US) displays, and whether this information altered drainage techniques.

RESULTS: Targeted fluid collections were visualized in all patients. 3D US added information in 11 of 16 patients (69%) that, in turn, resulted in adjustment of interventional technique in eight of 16 patients (50%). Specific features of 3D US that provided new information included the simultaneous display of three orthogonal US images, display of reconstructed US image plane orientations not possible with 2D US, and the ability to interactively scroll images through complex structures to assess for communication between the loculations. An attached needle guide was used in 15 of 16 patients to improve the precision of needle placement.

CONCLUSION: Endocavitary 3D US is feasible for assistance in transvaginal and transrectal drainage procedures, usually adds new information, frequently alters interventional technique, and permits precise access needle placement.