Three-dimensional ultrasound in diagnosis of uterus septus

Objective To summarize the sonographic features of uterus septus on coronal plane of three-dimensional ultrasound(3DUS).Methods A total of 87 patients who were suspected as uterus septus on transvaginal two-dimensional ultrasound(2DUS)were examined by transvaginal 3DUS.Then the coronal plane images were acquired.The fundus,cavity and cervix were analyzed.The depth of fundal cleft and the angle at the central point of the septum were measured.Results Among the 87 cases with hysterosalpingography(HSG),hysteroscopy,combined hysteroscopy laparoscope or magnetic resonance imaging(MRI),21 cases were diagnosed as complete septate uterus(9 with normal cervical,12 with cervical septum),56 cases as incomplete septate uterus,5 cases as arcuate uterus,3 cases as bicornuate uterus,and 2 cases as normal uterus which had intrauterine adhesions.The diagnostic results of 3DUS were all confirmed(87/87).Using 2DUS,the correct diagnosis was obtained in 75cases,however 12 cases were misdiagnosed(5 arcuate uterus,3 bicornuate uterus and 2 normal uterus were misdiagnosed as incomplete septate uterus;2 cervical septum were misdiagnosed as normal cervix).The sonographic features of the 87 uterus on coronal plane were:(1)77 septate uterus had convex(in 71 cases)or minimally depressed fundus(in 6 cases,cleft ≤1.0 cm),the Y-shaped(56 incomplete septate uterus with septum not extending into cervix)or V-shaped cavity(21 complete septate uterus with septum extending into cervix),and an acute angle at the central point of septum.(2)5 arcuate uterus had an obtuse angle at the central point of septum.(3)3 bicornuate uterus had fundal depression more than 1 cm and were divided into two cornuas.(4)2 normal uterus with intrauterine adhesions had normal uterine cavity and irregular adhesions.Conclusions Transvaginal 3DUS could display a good coronal plane,on which the relationship of the cavity and the fundus,the depth of fundal cleft and the angle at the central point of the septum can be well depicted and measured.Transvaginal 3DUS was a very practical,reliable and noninvasive method to diagnose septate uterus.