Authors: Tarek M. Toppozada, Samir M. Elsayed, Ahmed F. Galal
Objective: To establish the accuracy of three dimensional sonohysterography (3D-TVUS) compared with magnetic resonance imaging (MRI) in the differentiation between septate, bicornuate, and arcuate uterus.
Patients and Methods: Fourty women suspected to have septate, bicornuate uterus by examination by hysterosalpingography and/or two dimensioned ultrasound the patients were evaluated with 3D-Sonohysterography and MRI followed by combined hysteroscopy and laparoscopy. Sensitivity and specificily, positive predictive values, and negative predictive values were calculated using the endoscopy as the gold standard method of diagnosis.
Results: Three-dimensional sonohysterography in differentiation of septate from bicornuate and arcuate uterus, has a sensitivity of 90%, specificity 94%, PPV 91%, NPV 95%, with overall accuracy 93% while magnetic resonance imaging, had a sensitivity of 95%, specificity 100%, PPV 94%, NPV 96%, with overall accuracy 97%.
Conclusion: Despite MRI is superior over 3D-Sonohysterography in differentiation between septate from bicornuate uterus, Three-dimensional SIS has higher accuracy in the differentiation between septate and bicornuate uterus, so it is recommended as the first step in evaluation of the uterine cavity in work up of infertility and recurrent miscarriage.
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