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The Z Technique: An Easy Approach to the Display of the Midcoronal Plane of the Uterus in Volume Sonography

Departments of Obstetrics and Gynecology (A.Z.A., S.S., S.B.) and Epidemiology and Biostatistics (Y.Z.), Eastern Virginia Medical School, Norfolk, Virginia USA.

Address correspondence to Alfred Z. Abuhamad, MD, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Hofheimer Hall, Suite 310, 825 Fairfax Ave, Norfolk VA 23507 USA. E-mail: abuhamaz{at}evms.edu

Objective. The purpose of our study was to evaluate the ease of learning and clinical applicability of a technique (Z technique) for display of the midcoronal plane of the uterus in volume sonography. Methods. Eight physicians were randomly assigned to 2 groups, A and B, after being instructed on the basic principles of post processing of sonographic volumes. Physicians in group A were asked to individually display the midcoronal plane of the uterus in each of five 3-dimensional volumes of uteri. Physicians in group B were instructed on the Z technique and were then asked to individually display the midcoronal plane of the uterus in the same volumes as group A. The time needed for display of the midcoronal plane of the uterus and the quality of the midcoronal plane image retrieved were recorded for each volume. Results. The mean time required to display the midcoronal plane of the uterus for all volumes was 47.7 seconds in group B compared with 110.7 seconds in group A (P = .002). Furthermore, a significant improvement in time performance was seen for physicians in group A after learning the Z technique (23.2 seconds after compared with 110.7 seconds before; P = .0001). The quality of the image produced was notably better for all physicians after learning the Z technique. Conclusions. The Z technique is an easy technique to learn. Physicians who learn this technique are able to retrieve the midcoronal plane of the uterus faster and improve its image quality in volume sonography.

Key Words: coronal plane • 3-dimensional sonography • uterus • volume sonography • Z technique

Abbreviations: 3D, 3-dimensional • 2D, 2-dimensional

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