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

Authors

  • Abdelaziz E. Tammam Department of Obstetrics & Gynaecology, Faculty of Medicine, South Valley University, Qena, Egypt
  • Mostafa M. Khodry Department of Obstetrics & Gynaecology, Faculty of Medicine, South Valley University, Qena, Egypt
  • Shymaa M. A. Elnagar Department of Obstetrics & Gynaecology, Faculty of Medicine, South Valley University, Qena, Egypt
  • Ahmed H. Abdella Department of Obstetrics & Gynaecology, Faculty of Medicine, South Valley University, Qena, Egypt
  • Sayed A. M. Taha Department of Obstetrics & Gynaecology, Faculty of Medicine, South Valley University, Qena, Egypt

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20150692

Keywords:

3D transvaginal ultrasound, Clinical implementation, Uterine cavity

Abstract

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.

References

Moeglin D, Benoit B, De Ziegler D. Advantages of studying the frontal plane of the uterine cavity in 3D ultrasound. Contracept Fertil Sex. 1999;27:710-20.

Ayoubi JM, Fanchin R, Ferretti G, Pons JC, Bricault I. Three-dimensional ultrasonographic reconstruction of the uterine cavity: toward virtual hysteroscopy? Eur Radiol. 2002;12:2030-3.

Kupesic S, Kurjak A, Skenderovic S, Bjelos D. Screening for uterine abnormalities by three-dimensional ultrasound improves perinatal outcome. Perinat Med. 2002;30:9-17.

Salim R, Woelfer B, Backos M, Regan L, Jurkovic D. Reproducibility of three-dimensional ultrasound diagnosis of congenital uterine anomalies. Ultrasound Obstet Gynecol. 2003;21:578-82.

La Torre R, De Felice C, De Angelis C, Coacci F, Mastrone M, Cosmi EV. Transvaginal sonographic evaluation of endometrial polyps: a comparison with two dimensional and three dimensional contrast sonography. Clin Exp Obstet Gynecol. 1999;26:171-3.

Raga F, Bonilla–Musoles F, Blanes J, Osborne N.Congenital Mullerian Anomalies: Diagnostic accuracy of three–dimensional ultrasound. Fertile Steril. 1996;65:523-8.

Balen FG, Allen CM, Gardener JE, Siddle NC, Lees WR. Three-Dimensional reconstruction of ultrasound images of the uterine cavity. Br J Radiol 1993;66:588-91.

Fenester A, Downey DB. Three dimensional ultrasound imaging : a review. IEEE Eng Med Biol 1996; 15:41- 51.

Deutch TD, Abuhamad AZ. The role of 3-dimensional ultrasonography and magnetic resonance imaging in the diagnosis of Mullerian duct anomalies: a review of the literature. J Ultrasound Med 2008;27:413–23.

Ghada K. Gouhar and Soha Siam. Uterine septum structure and reproductive performance: Role of 3D TVU and MRI. The Egyptian Journal of radiology and nuclear Medicine. 2013;44:357-65.

Ghi T, Casadio P, Kuleva M, et al. Accuracy of three-dimensional ultrasound in diagnosis and classification of congenital uterine anomalies. Fertil Steril. 2009;92:808–13.

Alborzi S, Dehbashi S, Parsanezhad M. Differential diagnosis of septate and bicornuate uterus by sonohysterography eliminates the need for laparoscopy. Fertil Steril. 2002;78:176–8.

Saleem SN. MR Imaging diagnosis of uterovaginal anomalies: current state of the art. Radiographics. 2003;23:e13.

Kiyokawa K, Masuda H, Fuyuki T, Koseki M, Uchida N and Fukuda T. Three dimensional hysterosalpingocontrast-sonography “3D-Hycosy” as an outpatient procedure to assess infertile women: a

pilot study. Ultrasound Obstet Gynecol 2000;16:648-54.

Kupesic. Clinical implications of sonographic detection of uterine anomalies for reproductive outcome. Ultrasound Obstet Gynecol. 2001;18(4):387-400.

Kyei-Mensah A, Zaidi J, Pittrop R, Shaker AA, Campbell S, Tan SL. Threedimensional ultrasound: accuracy of follicular volume measurements. Fertil. Steril. 1996;65:371-6.

Makris N, Kalmantis K, Skartados N, Papadimitriou A, Mantzaris G, Antsaklis A. Three-dimensional hysterosonography versus hysteroscopy for the detection of intracavitary uterine abnormalities. Int J Gynaecol Obstet. 2007;97:6–9.

Bermejo C, Martı´nez Ten P, Cantarero R, Diaz D, Pe´rez Pedregosa J, Barro´ n E, et al. Three-dimensional ultrasound in the diagnosis of mu¨ llerian duct anomalies and concordance with magnetic resonance imaging. Ultrasound Obstet Gynecol. 2010;35:593–601.

Propst AM, Hill JA. Anatomic factors associated with recurrent pregnancy loss. Semin Reprod Med. 2000;18:341–50.

Troiano RN. Magnetic resonance imaging of mullerian duct anomalies of the uterus. Top Magn Reson Imaging. 2003;14:269–79.

Todd D, Deutch MD, Alfred Z, Abuhamad MD. The role of 3-dimensional ultrasonography and magnetic resonance imaging in the diagnosis of mu¨ llerian duct anomalies. J Ultrasound Med. 2008;27:413–23.

Faivre E, Fernandez H, Deffieux X, Gervaise A, Frydman R, Levaillant JM. Accuracy of three-dimensional ultrasonography in differential diagnosis of septate and bicornuate uterus compared with office hysteroscopy and pelvic magnetic resonance imaging. J Minim Invasive Gynecol. 2012;19(1):101–6.

Jurkovic D. Three-dimensional ultrasound in gynecology: a critical evaluation. Ultrasound Obstet Gynecol. 2002;19:109-117.

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Published

2017-02-10

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Original Research Articles