C Exacoustos

Publications (74)162.82 Total impact

• Article: Automated three-dimensional coded contrast hysterosalpingo-contrast-sonography: feasibility in office tubal patency testing.

  C Exacoustos, A Di Giovanni, B Szabolcs, V Romeo, M E Romanini, Danielle Luciano, E Zupi, D Arduini
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  ABSTRACT: Objective: To evaluate the feasibility of transvaginal hystero-salpingo-contrast-sonography (TVS HyCoSy) with a new automated three dimensional coded contrast imaging software (3D CCI) (GE Healthcare, Zipf, Austria) in the evaluation of tubal patency and visualization of tubal course. Methods: Patients undergoing TVS HyCoSy with automated 3D CCI software were prospectively evaluated. First, to evaluate the feasibility of the 3D visualization of tubal course we did two consecutive volume acquisitions while injecting contrast agent (SonoVue, Bracco International, Amsterdam, The Netherlands). Then we performed a conventional 2D real time HyCoSy to confirm tubal status by detection of saline and air bubbles moving through the tube and around the ovaries. The visualization with CCI of the contrast agent around the ovaries, the side effects and pain during and after the procedure were also evaluated. Results: 126 patients (for a total of 252 tubes) underwent 3D CCI HyCoSy followed by 2D real time HyCoSy. After both procedures (3D and 2D evaluations), bilateral tubal patency was observed in 111 patients, bilateral tubal occlusion in 4 patients and unilateral tubal patency in 11 patients. Concordance rate for tubal status between first and second 3D volume acquisition and the final 2D real time evaluation was 84% and 97% respectively. A pain score >5 (0-10 VAS scale) was recorded in 58% of patients during procedure but a pain score ≤ 5 was recorded in 85.7 % of patients immediately after the procedure. Conclusions: TVS HyCoSy with automated 3D CCI technology retains the advantages of conventional 2D HyCoSy while overcoming the disadvantages. Automated 3D volume acquisition permits the visualization of the tubal course by creating images of the tubes on the coronal view and obtaining a volume, so the tubal course can be evaluated in space. This allows less experienced operators to easily evaluate the tubal course. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
  Ultrasound in Obstetrics and Gynecology 05/2012; · 3.01 Impact Factor
• Article: Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology.

  C Exacoustos, L Brienza, A Di Giovanni, B Szabolcs, M E Romanini, E Zupi, D Arduini
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  ABSTRACT: To correlate with histopathological features the adenomyosis-induced morphological alterations of the outer myometrium and the inner myometrium ('junctional zone', JZ) detectable on two- (2D) and three-dimensional (3D) transvaginal ultrasound imaging (TVS), and to evaluate their diagnostic accuracy for adenomyosis. Premenopausal patients scheduled for hysterectomy for benign pathology were enrolled in this prospective study. Before hysterectomy all patients underwent detailed 2D-TVS and 3D volume acquisition of the entire uterus. The major sonographic signs of adenomyosis were noted. On the multiplanar coronal and longitudinal views obtained by 3D-TVS we measured the maximum and minimum JZ thickness from the basal endometrium to the internal layer of the outer myometrium (JZmax, JZmin), the difference between them (JZdif = JZmax - JZmin) and the ratio JZmax/total maximum myometrial thickness. Results of these examinations were correlated blindly to the presence of adenomyosis on histological specimens. A total of 72 premenopausal patients underwent 2D- and 3D-TVS before hysterectomy. The histological prevalence of adenomyosis was 44.4% (32/72 patients). In diagnosing adenomyosis, the presence of myometrial cysts was the most specific 2D-TVS feature (specificity, 98%; accuracy, 78%) and heterogeneous myometrium was the most sensitive (sensitivity, 88%; accuracy, 75%). The 3D-TVS markers JZdif ≥ 4 mm and JZ infiltration and distortion had high sensitivity (88%) and the best accuracy (85% and 82%, respectively). For 2D-TVS and 3D-TVS, respectively, the overall accuracy for diagnosis of adenomyosis was 83% and 89%, the sensitivity was 75% and 91%, the specificity was 90% and 88%, the positive predictive value was 86% and 85% and the negative predictive value was 82% and 92%. The coronal section of the uterus obtained by 3D-TVS permits accurate evaluation and measurement of the JZ, and its alteration has good diagnostic accuracy for adenomyosis.
  Ultrasound in Obstetrics and Gynecology 04/2011; 37(4):471-9. · 3.01 Impact Factor
• Article: OC10.01: Rectal deep endometriosis: transrectal approach with transvaginal probe to assess the infiltration of rectal mucosa.

  C Exacoustos, E Zupi, B Szabolcs, V Romeo, C Amoroso, M Romanini, D Arduini
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):18. · 3.01 Impact Factor
• Article: OC13.06: Pregnancy rate after automated three-dimensional (3D) coded contrast imaging (CCI) hysterosalpingo-contrast sonography (HyCoSy).

  A Di Giovanni, C Exacoustos, V Romeo, B Szabolcs, E Vaquero, E Zupi, D Arduini
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):26. · 3.01 Impact Factor
• Article: OC25.04: Three dimensional ultrasound to assess the chemotherapy response of locally advanced cervical cancer.

  G Perniola, C Exacoustos, M Graziano, C Achilli, F Bellati, I Palaia, D Arduini, P Benedetti Panici
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):45. · 3.01 Impact Factor
• Article: OP16.04: Adenomyosis: three dimensional sonographic findings of the junctional zone in infertile patients.

  C Exacoustos, L Brienza, E Bertonotti, D Luciano, C Amoroso, E Vaquero, D Arduini
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):98. · 3.01 Impact Factor
• Article: OP31.02: Follow up in patients treated with conservative surgery for ovarian borderline tumors: role of transvaginal ultrasound.

  C Exacoustos, G Perniola, A Di Giovanni, M Romanini, V Lanzilotta, F Rossi, P Benedetti Panici, D Arduini
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):142. · 3.01 Impact Factor
• Article: OP31.08: Pelvic relapse in patients treated for epithelial ovarian cancer. The role of transvaginal sonography.

  G Perniola, C Exacoustos, F Rossi, M Graziano, V Lanzillotta, V Di Donato, D Arduini, P Benedetti Panici
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):144. · 3.01 Impact Factor
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  Available from: mtsmedicale.it

  Article: Automated sonographic tubal patency evaluation with three-dimensional coded contrast imaging (CCI) during hysterosalpingo-contrast sonography (HyCoSy).

  C Exacoustos, A Di Giovanni, B Szabolcs, H Binder-Reisinger, C Gabardi, D Arduini
  Ultrasound in Obstetrics and Gynecology 11/2009; 34(5):609-12. · 3.01 Impact Factor
• Article: Intravenous contrast ultrasound examination using contrast-tuned imaging (CnTI) and the contrast medium SonoVue for discrimination between benign and malignant adnexal masses with solid components.

  A C Testa, D Timmerman, V Van Belle, E Fruscella, C Van Holsbeke, L Savelli, E Ferrazzi, F P G Leone, H Marret, F Tranquart, C Exacoustos, G Nazzaro, D Bokor, F Magri, S Van Huffel, G Ferrandina, L Valentin
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  ABSTRACT: To determine whether intravenous contrast ultrasound examination is superior to gray-scale or power Doppler ultrasound for discrimination between benign and malignant adnexal masses with complex ultrasound morphology. In an international multicenter study, 134 patients with an ovarian mass with solid components or a multilocular cyst with more than 10 cyst locules, underwent a standardized transvaginal ultrasound examination followed by contrast examination using the contrast-tuned imaging technique and intravenous injection of the contrast medium SonoVue(R). Time intensity curves were constructed, and peak intensity, area under the intensity curve, time to peak, sharpness and half wash-out time were calculated. The sensitivity and specificity with regard to malignancy were calculated and receiver-operating characteristics (ROC) curves were drawn for gray-scale, power Doppler and contrast variables and for pattern recognition (subjective assignment of a certainly benign, probably benign, uncertain or malignant diagnosis, using gray-scale and power Doppler ultrasound findings). The gold standard was the histological diagnosis of the surgically removed tumors. After exclusions (surgical removal of the mass > 3 months after the ultrasound examination, technical problems), 72 adnexal masses with solid components were used in our statistical analyses. The values for peak contrast signal intensity and area under the contrast signal intensity curve in malignant tumors were significantly higher than those in borderline tumors and benign tumors, while those for the benign and borderline tumors were similar. The area under the ROC curve of the best contrast variable with regard to diagnosing borderline or invasive malignancy (0.84) was larger than that of the best gray-scale (0.75) and power Doppler ultrasound variable (0.79) but smaller than that of pattern recognition (0.93). Findings on ultrasound contrast examination differed between benign and malignant tumors but there was a substantial overlap in contrast findings between benign and borderline tumors. It appears that ultrasound contrast examination is not superior to conventional ultrasound techniques, which also have difficulty in distinguishing between benign and borderline tumors, but can easily differentiate invasive malignancies from other tumors.
  Ultrasound in Obstetrics and Gynecology 11/2009; 34(6):699-710. · 3.01 Impact Factor
• Article: OP12.07: Feasibility of automated sonographic tubal patency evaluation using three-dimensional Coded Contrast Imaging.

  C Exacoustos, A Di Giovanni, B Szabolcs, M E Romanini, H Binder Resinger, C Gabardi, E Zupi, D Arduini
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):101. · 3.01 Impact Factor
• Article: OC15.03: Three dimensional sonographic assessment of septate uterus: correlation between morphology, volume and vascularity of the septum and reproductive outcome.

  C Exacoustos, E Vaquero, V Romeo, M Vendola, F Baiocco, E Valli, A Di Giovanni, D Arduini
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):29. · 3.01 Impact Factor
• Article: OC11.04: Three dimensional evaluation of adenomyosis: correlation of sonographic findings to histology.

  C Exacoustos, L Brienza, A G Cillis, E Bertonotti, A Amadio, C Amoroso, E Zupi, D Arduini
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):20. · 3.01 Impact Factor
• Article: P13.02: Reproductive outcome in patients with recurrent miscarriage and impaired resistance to uterine arteries blood flow treated with low dose aspirin and omega-3 fatty acids.

  C Exacoustos, N Lazzarin, E Vaquero, M E Romanini, A Di Giovanni, D Arduini
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):229-230. · 3.01 Impact Factor
• Article: Automated Sonographic Tubal Patency Evaluation Using Three-Dimensional Coded Contrast Imaging: Feasibility and Accuracy

  C. Exacoustos, A. Di Giovanni, B. Szabolcs, M. E. Romanini, Reisinger H. Binder, C. Gabardi, E. Zupi, D. Arduini
  Journal of Minimally Invasive Gynecology - J MINIM INVASIVE GYNECOL. 01/2009; 16(6).
• Article: OC059: Recurrent miscarriage: Three dimensional power Doppler evaluation of endometrial and subendometrial volume and vascularity and correlation to uterine arteries blood flow

  E. Vaquero, N. Lazzarin, C. Exacoustos, M. E. Romanini, E. Bertonotti, D. Arduini
  Ultrasound in Obstetrics and Gynecology 08/2008; 32(3):262 - 262. · 3.01 Impact Factor
• Article: OP11.05: Three‐dimensional sonographic evaluation of septate uterus after hysteroscopic metroplasty: correlation with pregnancy outcome

  E. Vaquero, N. Lazzarin, C. Exacoustos, C. Amoroso, A. Amadio, M. E. Romanini, E. Valli, D. Arduini
  Ultrasound in Obstetrics and Gynecology 09/2007; 30(4):491 - 492. · 3.01 Impact Factor
• Article: OP11.07: Transvaginal sonographic mapping of pelvic adhesions in women with chronic pelvic pain

  M. E. Romanini, G. Larciprete, A. Amadio, E. Bertonotti, C. Amoroso, C. Exacoustos, D. Arduini
  Ultrasound in Obstetrics and Gynecology 09/2007; 30(4):492 - 492. · 3.01 Impact Factor
• Article: OC196: The contribution of CNTI‐SonoVue in the classification of adnexal masses as benign or malignant: a multicenter study

  A. C. Testa, E. Fruscella, D. Timmerman, C. Van Holsbeke, L. Savelli, E. Ferrazzi, F. P. G. Leone, H. Marret, C. Exacoustos, G. De Placido, D. Bokor, G. Ferrandina, L. Valentin
  Ultrasound in Obstetrics and Gynecology 09/2007; 30(4):427 - 427. · 3.01 Impact Factor
• Article: OP05.05: Recurrent spontaneous abortion: uterine arteries blood flow and three‐dimensional sonographic evaluation of endometrial and subendometrial vascularity

  N. Lazzarin, E. Vaquero, C. Exacoustos, E. Bertonotti, A. Amadio, B. Cangi, M. E. Romanini, D. Arduini
  Ultrasound in Obstetrics and Gynecology 09/2007; 30(4):470 - 470. · 3.01 Impact Factor