title: Diagnostic accuracy of three-dimensional sonohysterography compared with office hysteroscopy and its interrater/intrarater agreement in uterine cavity assessment after hysteroscopic metroplasty.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of three-dimensional sonohysterography (3D-SIS) and office hysteroscopy in uterine cavity assessment after hysteroscopic metroplasty (HM) and determine the interrater/intrarater agreement for 3D-SIS.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  University hospital, private hospital, and clinic.
  
  
  METHODS
  One hundred forty-one women undergoing HM for septate uterus with a history of miscarriage and/or infertility.
  
  
  METHODS
  3D-SIS and office hysteroscopy at 6-8 weeks after HM.
  
  
  METHODS
  Shape of the uterine cavity, length of the fundal notch (≥1 or <1 cm), and the presence of intrauterine adhesions were assessed, and the interrater/intrarater agreement of 3D-SIS was evaluated in 30 randomly selected patients.
  
  
  RESULTS
  Uterine abnormalities were detected with the use of hysteroscopy in 18 (12.8%) of 141 women. 3D-SIS was highly accurate (97.2%), sensitive (97%), and specific (100%), with a positive predictive value of 100% and a negative predictive value of 85%. The diagnostic values of hysteroscopy and 3D-SIS were not significantly different (McNemar test). 3D-SIS showed substantial interrater/intrarater agreement regarding overall uterine cavity evaluation (κ = 0.79 and 0.78, respectively).
  
  
  CONCLUSIONS
  3D-SIS demonstrated substantial interrater/intrarater agreement for the postoperative evaluation of the uterine cavity, being as diagnostically accurate as hysteroscopy. The use of second-look hysteroscopy may be limited to cases that require reoperation.
authors.affiliation: Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland; Centermed Hospital and Clinic, Krakow, Poland; Ludwin and Ludwin Gynecology, Medical Center, Krakow, Poland. Electronic address: ludwin@cm-uj.krakow.pl.
authors.forename: Artur
authors.initials: A
authors.lastname: Ludwin
authors.affiliation: Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland; Centermed Hospital and Clinic, Krakow, Poland; Ludwin and Ludwin Gynecology, Medical Center, Krakow, Poland.
authors.forename: Inga
authors.initials: I
authors.lastname: Ludwin
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Silesia, Katowice, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Kudla
authors.affiliation: Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland.
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Pitynski
authors.affiliation: Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Banas
authors.affiliation: Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Jach
authors.affiliation: Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Knafel
mesh_terms: D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000592:standards; D007247:Infertility, Female / Q000000981:diagnostic imaging / Q000601:surgery; D015588:Observer Variation; D009819:Office Visits; D011446:Prospective Studies; D024162:Second-Look Surgery / Q000592:standards; D018084:Ultrasonography, Interventional / Q000592:standards; D014599:Uterus / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Sensitivity; hysteroscopic metroplasty; interrater/intrarater agreement; septate uterus; specificity; three-dimensional sonohysterography