title: Two- and three-dimensional ultrasonography and sonohysterography versus hysteroscopy with laparoscopy in the differential diagnosis of septate, bicornuate, and arcuate uteri.
abstract: OBJECTIVE
  To estimate the diagnostic accuracy and to compare the diagnostic value of 3-dimensional sonohysterography (3D-SIS), 3-dimensional transvaginal ultrasonography (3D-TVS), 2-dimensional sonohysterography (2D-SIS), and 2-dimensional transvaginal ultrasonography (2D-TVS) (initial and expert diagnosis) in the differential diagnosis of septate, bicornuate, and arcuate uteri.
  
  
  METHODS
  Prospective clinical study (Canadian Task Force II-2).
  
  
  METHODS
  University hospital and private hospital and clinic.
  
  
  METHODS
  A total of 117 women with a history of recurrent abortions or infertility and a 2D-TVS initial diagnosis of a septate, bicornuate, or arcuate uterus.
  
  
  METHODS
  Expert 2D-TVS, 3D-TVS, 2D-SIS, and 3D-SIS performed by experienced examiners and hysteroscopy with laparoscopy to establish the final diagnosis.
  
  
  RESULTS
  Hysteroscopy performed in conjunction with laparoscopy (HL) detected 23 arcuate, 60 septate, 22 bicornuate, and 12 normal uteri. 3D-SIS showed perfect diagnostic accuracy (100.0%) in general detection of uterine abnormalities, compared with initial 2D-TVS (77.8%), expert 2D-TVS (90.6%), 2D-SIS (94.0%), and 3D-TVS (97.4%). In the overall diagnosis of uterine anomalies, all of the diagnostic methods had statistically significantly better diagnostic value than initial 2D-TVS (p < .001), whereas 3D-SIS was the only method that was better than expert 2D-TVS (p < .001).
  
  
  CONCLUSIONS
  Although 3D-SIS was identical to HL, with the highest accuracy, there was no significant difference in diagnostic value between 3D-TVS with 2D-SIS and 3D-SIS or between expert 2D-TVS and 3D-TVS with 2D-SIS. The high diagnostic value of these ultrasonographic tools questions the need for endoscopy in the differential diagnosis of the most common congenital uterine anomalies.
authors: Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland. ludwin@cm-uj.krakow.pl
authors: Artur
authors: A
authors: Ludwin
authors: Kazimierz
authors: K
authors: Pityński
authors: Inga
authors: I
authors: Ludwin
authors: Tomasz
authors: T
authors: Banas
authors: Anna
authors: A
authors: Knafel
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014564:Urogenital Abnormalities / Q000000981:diagnostic imaging*; D014599:Uterus / Q000002:abnormalities / Q000000981:diagnostic imaging