Publication:

Three-dimensional transvaginal ultrasound: clinical implementation in assessing uterine cavity

Background Three-dimensional transvaginal ultrasonography (3D TVS) represents a new technique of imaging and provides a unique diagnostic tool for non-invasive examination of the uterine morphology and diagnosis of congenital uterine anomalies. In this study the clinical value of 3D TVS in diagnosis of uterine cavity abnormalities were evaluated.

Methods A prospective of diagnostic accuracy study included 226 patients with various clinical presentations; infertility, recurrent pregnancy loss, menstrual disorders and post-menopausal bleeding with suspected uterine cavity lesions or abnormality on two-dimensional (2D) TVS or hysterosalpingography (HSG). After taking consent, all patients were subjected to history taking, clinical examination, 3D TVS evaluation, magnetic resonance imaging (MRI) and finally endoscopic examination.

Results The 3D has 98% accuracy in infertile women in comparison to 87% for MRI. While with recurrent pregnancy loss, Concordance was 96% correct for 3D and 78% for MRI. The women with abnormal uterine bleeding, the accuracy of 3D was 100%, while with MRI was 74%. The sensitivity of 3D TVS was 97.8% and 100% specificity, positive and negative predictive value. While the sensitivity, specificity, positive and negative predictive values for MRI were 89.3%, 64%, 70.4% and 86.3% respectively.

Conclusions 3D TVS appears to be extremely accurate, less expensive and a rapid examination for the diagnosis and classification of uterine anomalies, more than MRI. Thus it may become the only mandatory step in the assessment of the uterine cavity.