Скачать или смотреть Endometrial Scratching Artifact on Sonohysterography

This is an example of endometrial scratching artifacts observed during sonohysterography.

Sonohysterography is a transvaginal ultrasound technique that improves visualization of the endometrium and uterine cavity, and helps to differentiate between lesions of endometrial and myometrial origin. It involves inserting a catheter into the uterine cavity through the cervix to inject sterile saline during transvaginal sonography. The fluid distends the cavity, pushing the walls of the endometrium apart. The anechoic saline is juxtaposed against the echogenic endometrium, allowing superb imaging of the uterine lining.

The tip of the sonohysterography catheter can easily scratch the soft endometrium, lifting flaps of loose echogenic tissue and creating grooves in the smooth endometrial surface. These mobile echogenic protrusions are innocuous but they should not be mistaken for intrauterine pathology. They sometimes resemble endometrial polyps or changes of endometrial hyperplasia.

Intentional endometrial scratching, or injury, defined as medically administered damage to the inner lining of the uterus, was first demonstrated as a beneficial procedure in assisted reproductive techniques in 2003. This intentional endometrial injury significantly improves the clinical pregnancy rate, including the number of babies born, when performed in women who are undergoing assisted reproductive treatment, such as IVF.

Hypotheses regarding the underlying mechanism include: that endometrial scratching during the previous cycle might induce decidualization, increasing the chance of implantation; that it induces a significant increase in the secretion of cytokines, interleukins, growth factors, macrophages and dendritic cells, all of which might be beneficial to embryo implantation; and that endometrial scratching might lead to better synchronicity between the endometrium and the transferred embryo.

Have a look at this study:

"Endometrial scratching performed in the non-transfer cycle and outcome of assisted reproduction: a randomized controlled trial"
http://onlinelibrary.wiley.com/doi/10...

Stavros Mousourakis (Mussurakis), MD, FRCR
Clinical Radiologist
Ultrasound, Fetal & Women's Imaging Specialist

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