International Journal of
Reproductive Biomedicine
Sat, Apr 20, 2024
[Archive]
Volume 12, Issue 8 (8-2014)
IJRM 2014, 12(8): 547-0 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Niknejadi M, Akhbari F, Niknejad F, Khalili G, Shiva M. Comparison of two dimensional and live three dimensional ultrasounds for the diagnosis of septated uterus. IJRM 2014; 12 (8) :547-0
URL: http://ijrm.ir/article-1-572-en.html
URL: http://ijrm.ir/article-1-572-en.html
1- Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran , mniknezhady@yahoo.co.uk
2- Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
3- Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
4- Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
2- Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
3- Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
4- Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
Abstract: (5677 Views)
Background: Traditionally, septate uterus was diagnosed with invasive method like hysterosalpingography and hysteroscopy. Nowadays transvaginal ultrasonography was reported to be a sensitive tool for detection of septate uterus too.
Objective: The objective of the present study was to evaluate the application of two dimensional ultrasound (2-DUS) and real time three dimensional ultrasound (3-DUS) in differentiating various type of septated uterus. Hysteroscopy confirmation was assigned as the gold standard.
Materials and Methods: This retrospective study was performed among 215 infertile women with suspected septate uterus from October 2008 to July 2012. An inclusion criterion was septated uterus based on HSG or experiencing abortion, preterm labor, or recurrent IVF failure. Fusion anomalies were excluded from the study (unicornuate, bicornuate and didelphys anomalies). The results of 3D and 2D sonographies were compared, while they were confirmed by hysteroscopy result in detection of septated uterus. Kappa index for agreement between 2DUS and hysteroscopy, as well as 3-DUS and hysteroscopy in detection of septate uterus was carried out. By receiver operating characteristic (ROC) curve, cut off points for predicting the kind of anomalies were proposed.
Results: The women were evaluated by 2-DUS (n=89) and (II) 3-DUS (n=126). All women underwent hysteroscopy, following 2-DUS and 3-DUS at the same or subsequent cycle. The results of kappa (K) index were 0.575 and 0.291 for 3-DUS and hysteroscopy, as well as 2-DUS and hysteroscopy, respectively. Also, the cutoff points were 27% for arcuate and subseptate, and 35% for differentiating septate and subseptate.
Conclusion: Real time 3-DUS has better ability for visualization both uterine cavity and the fundal uterine, so it has higher agreement in detection of septate uterus than 2-DUS.
Objective: The objective of the present study was to evaluate the application of two dimensional ultrasound (2-DUS) and real time three dimensional ultrasound (3-DUS) in differentiating various type of septated uterus. Hysteroscopy confirmation was assigned as the gold standard.
Materials and Methods: This retrospective study was performed among 215 infertile women with suspected septate uterus from October 2008 to July 2012. An inclusion criterion was septated uterus based on HSG or experiencing abortion, preterm labor, or recurrent IVF failure. Fusion anomalies were excluded from the study (unicornuate, bicornuate and didelphys anomalies). The results of 3D and 2D sonographies were compared, while they were confirmed by hysteroscopy result in detection of septated uterus. Kappa index for agreement between 2DUS and hysteroscopy, as well as 3-DUS and hysteroscopy in detection of septate uterus was carried out. By receiver operating characteristic (ROC) curve, cut off points for predicting the kind of anomalies were proposed.
Results: The women were evaluated by 2-DUS (n=89) and (II) 3-DUS (n=126). All women underwent hysteroscopy, following 2-DUS and 3-DUS at the same or subsequent cycle. The results of kappa (K) index were 0.575 and 0.291 for 3-DUS and hysteroscopy, as well as 2-DUS and hysteroscopy, respectively. Also, the cutoff points were 27% for arcuate and subseptate, and 35% for differentiating septate and subseptate.
Conclusion: Real time 3-DUS has better ability for visualization both uterine cavity and the fundal uterine, so it has higher agreement in detection of septate uterus than 2-DUS.
Type of Study: Original Article |
References
1. Gaucherand P, Awada A, Rudigoz RC, Dargent D. Obstetricalprognosis of septate uterus: A plea for treatment of the septum. Eur J Obstet Gynecol Reprod Biol 1994; 54: 109-112. [DOI:10.1016/0028-2243(94)90247-X]
2. Valdes C, Malini S, Malinak LR. Ultrasound evaluation of female genital tract anomalies: A review of 64 cases. Am J Obstet Gynecol 1984; 149: 285-292. [DOI:10.1016/0002-9378(84)90228-X]
3. Nicolini U, Bellotti M, Bonazzi B, Zamberletti D, Candiani GB. Can ultrasound be used to screen uterine malformation? Fertil Steril 1987; 47: 89-93. [DOI:10.1016/S0015-0282(16)49941-3]
4. Ghi T, Casadio P, Kuleva M, Perrone AM, Savelli L, Giunchi S, et al. Accuracy of three-dimensional ultrasound in diagnosis and classification congenital uterine anomalies. Fertil Steril 2009; 92: 808-813. [DOI:10.1016/j.fertnstert.2008.05.086]
5. Zohav E, Melcer Y, Tur-Kaspa I, Rabinson J, Anteby EY, Orvieto R. The role of 3-dimensional ultrasound for the diagnosis of congenital uterine anomalies. Open J Obstet Gynecol 2011; 1: 238-241. [DOI:10.4236/ojog.2011.14047]
6. Jurkovic D, Geipel A, Gruboeck K, Jauniaux E, Natucci M, Campbell S. Three dimensiona ultrasound for the assessment of uterine anatomy and detection of congenital anomalies: A comparison with hysterosalpingography and two dimensional sonography. Ultrasound Obstet Gynecol 1995; 5: 233-237. [DOI:10.1046/j.1469-0705.1995.05040233.x]
7. Zafarani F, Ahmadi F. Evaluation of intrauterine structural pathology by three-dimensional sonohys-terography using an extended imaging method. Int J Fertil Steril 2013; 7: 1-6.
8. Mohamed M, Momtaz MD, Alaa N, Ebrashy MD, Ayman A, Marzouk MD. Three-dimensional ultrasonography in the evaluation of the uterine cavity. Middle East Fertil Soc J 2007; 12: 41-46.
9. Wu MH, Hsu CC, Huang KE. Detection of congenital mullerian anomalies using three-dimensional ultrasound. J Clin Ultrasound 1997; 25: 487-492.
https://doi.org/10.1002/(SICI)1097-0096(199711/12)25:9<487::AID-JCU4>3.0.CO;2-J [DOI:10.1002/(SICI)1097-0096(199711/12)25:93.0.CO;2-J]
10. Homer HA, Li TC, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertil Steril 2000; 73: 1-14. [DOI:10.1016/S0015-0282(99)00480-X]
11. Raziel A, Arieli S, Bukovsky I, Caspi E, Golan A. Investigation of the uterine cavity in recurrent aborters. Fertil Steril 1994; 62: 1080-1082. [DOI:10.1016/S0015-0282(16)57080-0]
12. Raga F, Bonilla-Musoles F, Blanes J, Osborne NG. Congenital Müllerian anomalies: diagnostic accuracy of three-dimensional ultrasound. Fertil Steril 1996; 65: 523-528. [DOI:10.1016/S0015-0282(16)58147-3]
13. Ahmadi F, Zafarani F, Haghighi H, Niknejadi M, Vosough Taqi Dizaj A. Application of 3D Ultrasonography in Detection of Uterine Abnormalities. Int J Fertil Steril 2011; 4: 144-147.
14. Ribeiro SC, Tormena RA, Peterson TV, Gonzáles MO, Serrano PG, de Almeida JAM, et al. Müllerian duct anomalies: review of current management. Sao Paulo Med J 2009; 127: 92-96. [DOI:10.1590/S1516-31802009000200007]
15. Moini A, Mohammadi S, Hosseini R, Eslami B, Ahmadi F. Accuracy of 3-Dimensional Sonography for Diagnosis and Classification of Congenital Uterine Anomalies. J Ultrasound Med 2013; 32: 923-927. [DOI:10.7863/ultra.32.6.923]
16. Ferreira AC, Filho FM, Nicolau LG, Francisco M, Gallarreta P. de Paula WM, Gomes DC. Three-dimensional ultrasound in gynecology: uterine malformations. Radiol Bras 2007; 40: 131-136. [DOI:10.1590/S0100-39842007000200013]
17. Salim R, Jurkovic D. Assessing congenital uterine anomalies: the role of three-dimensional ultrasonography. Best Pract Res Clin Obstet Gynaecol 2004; 18: 29-36. [DOI:10.1016/j.bpobgyn.2003.09.001]
18. Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simón C, Pellicer A. Reproductive impact of congenital Müllerian anomalies. Hum Reprod 1997; 12: 2277-2781. [DOI:10.1093/humrep/12.10.2277]
19. Deutch TD, Abuhamad AZ. The role of 3-dimensional ultrasonography and magnetic resonance imaging in the diagnosis of müllerian duct anomalies: a review of the literature. J Ultrasound Med 2008; 27: 413-423. [DOI:10.7863/jum.2008.27.3.413]
20. Saravelos SH, Cocksedge KA, Li TC. Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod Update 2008; 14: 415-429. [DOI:10.1093/humupd/dmn018]
21. Kupesic S, Kurjak A. Septate uterus: detection and prediction of obstetrical complications by different forms of ultrasonography. J Ultrasound Med 1998; 17: 631-663. [DOI:10.7863/jum.1998.17.10.631]
22. Kupesid S, Kurjak S, Skenderovic S, Bjelos D. Screening for uterine abnormalities by three-dimensional ultrasound improves perinatal outcome. J Perinat Med 2002; 30: 9-17.
23. Niknejadi M, Haghighi H, Ahmadi F, Niknejad F, Chehrazi M, Vosough A, et al. Diagnostic Accuracy of Transvaginal Sonography in the Detection of Uterine Abnormalities in Infertile Women. Iran J Radiol 2012; 9: 139-144. [DOI:10.5812/iranjradiol.8063]
24. Byrne J, Nussbaum-Blask A, Taylor WS, Rubin A, Hill M, O'Donnell R, et al. Prevalence of Müllerian duct anomalies detected at ultrasound. Am J Med Genet 2000; 94: 9-12.
https://doi.org/10.1002/1096-8628(20000904)94:1<9::AID-AJMG3>3.0.CO;2-H [DOI:10.1002/1096-8628(20000904)94:13.0.CO;2-H]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
