Septate or bicornuate uterus: Accuracy of three-dimensional trans-vaginal ultrasonography and pelvic magnetic resonance imaging

To estimate the accuracy of 3-dimensional transvaginal ultrasonography (3D-TVUS), hysterosalpingography (HSG) and pelvic magnetic resonance imaging (MRI) in the differentiation between septate and bicornuate uterus. Thirty-six patients with suspected septate or bicornuate uterus on 2D ultrasound or...

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Bibliographic Details
Published in:Egyptian journal of radiology and nuclear medicine 2014-09, Vol.45 (3), p.987-995
Main Authors: Abo Dewan, Khaled Abd AlWahab, Hefeda, Mohamed Mohamed, ElKholy, Dina Gamal ElDein
Format: Article
Language:English
Subjects:
Bicornuate uterus
Mullerian duct anomalies
Pelvic magnetic resonance imaging
Septate uterus
Three dimensional ultrasound
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Summary:To estimate the accuracy of 3-dimensional transvaginal ultrasonography (3D-TVUS), hysterosalpingography (HSG) and pelvic magnetic resonance imaging (MRI) in the differentiation between septate and bicornuate uterus. Thirty-six patients with suspected septate or bicornuate uterus on 2D ultrasound or hysterosalpingography (HSG) underwent 3D-TVUS examination, MR imaging, diagnostic laparoscopy and hysteroscopy. HSG was performed only for those patients who did not undergo the procedure before (21 patients), we retrospectively revised the hysterosalpingography of 15 patients performed outside our hospital with acceptable quality. HSG showed sensitivity of 77.4%, specificity of 60% and overall accuracy of 75% in the differentiation between the septate and bicornuate uterus. MRI showed sensitivity of 93.5%, specificity of 80%, PPV of 96.6% and negative predicative value of 66.6%, with overall accuracy of 91.6%. The 3D ultrasound showed the highest diagnostic parameters, with sensitivity of 96.7%, specificity of 100%, PPV of 100% and negative predicative value of 83.3%, with overall accuracy of 97.2%. Transvaginal 3-D ultrasonography is accurate for diagnosis and differentiation between septate uterus and bicornuate uterus. We recommend 3-D transvaginal ultrasonography as the first and only mandatory step in the assessment of the uterine cavity in patients with a suspected septate or bicornuate uterus, especially before planning surgery. MRI should be preserved for patients in whom 3D TVS is not possible like virgins.
ISSN:0378-603X
DOI:10.1016/j.ejrnm.2014.04.001