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Comparison of two dimensional and live three dimensional ultrasounds for the diagnosis of septated uterus.

Niknejadi M, Akhbari F, Niknejad F, Khalili G, Shiva M - Iran J Reprod Med (2014)

Bottom Line: Hysteroscopy confirmation was assigned as the gold standard.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Uterus measuring: in coronal reformatted section, fundal depth is 6 mm and interosteal line is 38.7 mm
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Figure 1: Uterus measuring: in coronal reformatted section, fundal depth is 6 mm and interosteal line is 38.7 mm

Mentions: Three measurements were taken from patients undergoing 3-DUS as follows: (I) Uterine cavity width was known as the distance between the two internal tubal ostia (referred as interosteal line at the midpoint of uterine cornea), (II) Depth of fundal indentation or the septum length was known as the distance between the midpoint of the line adjoining the tubal ostia and the distal tip of fundal indentation (mm), and (III) Ratio of the septal length to interosteal line (%) (Figure1) (4). Hysteroscopy was used as the gold standard which was performed under general anesthesia using a Storz 4mm hysteroscope (Karl Storz GmbH & Co., Tuttlingen, Germany) by an expert gynecologist.


Comparison of two dimensional and live three dimensional ultrasounds for the diagnosis of septated uterus.

Niknejadi M, Akhbari F, Niknejad F, Khalili G, Shiva M - Iran J Reprod Med (2014)

Uterus measuring: in coronal reformatted section, fundal depth is 6 mm and interosteal line is 38.7 mm
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4233313&req=5

Figure 1: Uterus measuring: in coronal reformatted section, fundal depth is 6 mm and interosteal line is 38.7 mm
Mentions: Three measurements were taken from patients undergoing 3-DUS as follows: (I) Uterine cavity width was known as the distance between the two internal tubal ostia (referred as interosteal line at the midpoint of uterine cornea), (II) Depth of fundal indentation or the septum length was known as the distance between the midpoint of the line adjoining the tubal ostia and the distal tip of fundal indentation (mm), and (III) Ratio of the septal length to interosteal line (%) (Figure1) (4). Hysteroscopy was used as the gold standard which was performed under general anesthesia using a Storz 4mm hysteroscope (Karl Storz GmbH & Co., Tuttlingen, Germany) by an expert gynecologist.

Bottom Line: Hysteroscopy confirmation was assigned as the gold standard.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus