The role of 3-dimensional ultrasound for the diagnosis of congenital uterine anomalies

Objectives: To demonstrate the value of 3-dimensional (3-D) ultrasound (US) in the diagnosis of congenital uterine anomalies. Methods: Fifty one infertile patients referred to our US unit during 12 years period, with suspected diagnosis of congenital uterine anomalies by previous HSG or 2D US examinations, were evaluated by transvaginal 3-D US. The 3-D US diagnoses were compared to the initial HSG diagnosis, and to hysteroscopic evaluation when performed. Results: 3-D scan confirmed the initial HSG diagnosis in 27 out of 51 (52.9%) women. The concordancy rates between the initial diagnosis by HSG and 3-D US results were 30.4% for bicornuate uterus; 75% for arcuate uterus; 83% for septate uterus; and 80% for unicornuate uterus. Of the 13 cases with normal HSG and suspicious 2-D US, 30.8% were found to be normal by 3D sonography. In cases where hysteroscopy was done, the results were 100% in concordance with the 3-D US evaluations. Conclusions: 3-D US is an accurate test for the assessment of uterine congenital anomalies. Its ability to concomitantly visualized, the external uterine contour with the uterine cavity on the same coronal plan, makes this noninvasive, easy to perform test the procedure of choice for the diagnosis of uterine anomalies.