Role of 3D Ultrasound Scan in Diagnosis of Uterine Cavity Abnormalities in an Infertile Population A Cross-Sectional Study

Backgrounds:To evaluate the accuracy of three-dimensional transvaginal sonography (3D-TVS) in diagnosis of uterine cavity abnormalities among infertile women.Material and method: This was a cross-sectional study performed in Royan Institute, Tehran, between April 2012 and March 2013. All infertile women who were booked for hysteroscopy during this period of time were recruited in the study. Patients underwent preoperative 3D-TVS by an expert radiologist and hysteroscopy was performed by an expert surgeon. Patient’s history, 3D-TVS findings and hysteroscopy results were assessed to collect data. Agreement between ultrasound findings & hysteroscopy results, sensitivity, specificity, positive & negative predictive values, and accuracy of 3D-TVS in diagnosis of congenital and acquired uterine disorders were calculated by SPSS18 software using Cross-tabs, Kappa test, and other statistic analysis.Result: Totally, 153 women were recruited in the investigation. Patients aged 30.78±4.79 years in average and the duration of infertility was 4.2±2.91 years among them. Overall diagnostic accuracy of 3D TVS in diagnosis of congenital uterine anomalies and acquired lesions was calculated 92.8% with Kappa value of 82.3, indicating a good agreement between ultrasound findings and hysteroscopy results. Sensitivity, specificity, positive & negative predictive values of 3D TVS in diagnosis of uterine disorders was calculated 94.55%, 88.37%, 95.41%, and 86.36% respectively.Conclusion: Our study demonstrated that 3D TVS had a good reliable agreement with hysteroscopy in the detection of uterine lesions among infertile women. Therefore, as an accurate cost-effective outpatient tool, it can decrease the number of unnecessary diagnostic hysteroscopies.