Application of three-dimensional transvaginal sonography in diagnosis of mediastinal uterus

Objective To explore the clinical value of three-dimensional transvaginal sonography in diagnosis of mediastinal uterus. Methods Fifty-six patients with mediastinal uterus diagnosed by 2D ultrasound were examined by by three-dimensional transvaginal sonography to obtain coronal section of uterus, which showed uterine and cervical morphology. The depth of the bottom of the uterus, the angle on separate sides of endometrial, and the length of the diaphragm was measured, and were compared with the results from hysteroscopy or laparoscopy combined with hysteroscopy. Results There was 10 case of complete mediastinal uteru, 33 case of incomplete uterine mediastinum, 9 cases of arcuate uterus, three cases of uterine horns, and one case of normal uterus combined with intrauterine adhesions. The diagnosis results from three dimensional ultrasound were 100% consistant with the diagnosis from hysteroscopy or laparoscopy combined hysteroscopy, while the accurate rate with two dimensional ultrasound was only 77%. Conclusion Three-dimensional ultrasound imaging can visualize coronal section of uterine shape and morphology of the uterus, and can display the length of the diaphragm, the depth and the angle between the bottom sides of the palace of endometrial depression. Compared with two dimensional ultrasound, it has advantages in the differential diagnosis of arcuate uterus and uterine horns aspects and is worth of clinical application in diagnosis of uterine mediastinum.