DETECTION OF CONGENITAL MULLERIAN DUCT ANOMALIES USING 3-DIMENSIONAL ULTRASOUND

Purpose. The purpose of this study was to assess the value of 3-dimens ional sonography in the diagnosis of congenital mullerian duct anomali es, which cause infertility, preterm labor, and first trimester aborti on. Methods. A prospective study was undertaken in which 40 patients w ith histories of repeated spontaneous abortions or infertility were fi rst examined using conventional 2-dimensional sonography or hysterosal pingography. Three-dimensional transvaginal sonography was then perfor med. Results. Twenty-eight women had mullerian duct abnormalities, and 12 women had normal uterine anatomy. Mullerian duct defects detected in this study were unicornuate uterus (3), bicornuate uterus (3), comp lete or partial septate uterus (12), arcuate uterus (9), and didelphic uterus (1). The diagnosis of mullerian duct anomalies in these patien ts was confirmed by laparoscopic and/or hysteroscopic examinations. Th ree-dimensional sonography demonstrated all congenital uterine abnorma lities with a sensitivity and specificity of 100%. Separate uterus and bicornuate uterus could be correctly diagnosed using 3-dimensional so nography in 11 (92%) of 12 cases and 3 (100%) of 3 cases, respectively . These 2 abnormalities were commonly confused with each other using h ysterosalpingography and conventional sonography. Conclusions. Three-d imensional sonography with image reconstruction is less expensive and less invasive than hysterosalpingography for the assessment of uterine anatomy and diagnosis of mullerian duct abnormalities. The ability to visualize both the uterine cavity and the myometrium on a 3-dimension al scan facilitates the diagnosis of uterine anomalies and enables the differentiation of septate from bicornuate uteri for preoperative sur gical planning. (C) 1997 John Wiley & Sons, Inc.