Comparative Study of Hysteroscopy and 3D Ultrasound for Diagnosing Uterine Cavity Abnormalities.

OBJECTIVE

Hysteroscopy is the most accurate method for diagnosing intrauterine pathologies related to abnormal bleeding and infertility. The accuracy of three-dimensional (3D) ultrasonography and hysteroscopy were compared in identifying uterine cavity abnormalities.

MATERIAL AND

METHODS

A total of 139 cases of abnormal uterine bleeding or infertility first had two-dimensional and 3D ultrasound performed before hysteroscopy. Findings on 3D ultrasound and hysteroscopy were compared, and sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio were calculated.

RESULTS

Mean patients’ age was 36.5 (+/- SD 9.04). Three-dimensional ultrasound had a sensitivity of 88%, specificity of 94%, a positive predictive value of 96%, negative predictive value of 84%, likely ratio of 5,5, and accuracy of 90% in diagnosing uterine cavity abnormalities. Three-dimensional ultrasound had a high sensitivity and specificity for polyps (97% and 97%, respectively), congenital uterine malformations (100% and 99%, respectively) and submucous myoma (87% and 100%, respectively), but a low sensitivity and high specificity for uterine synechia (41% and 99%, respectively).

CONCLUSIONS

For diagnosing uterine cavity anomalies, 3D ultrasound is a useful tool and could replace diagnostic hysteroscopy for certain conditions, such as congenital uterine anomalies.