Department of Radiology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
Department of Obstetrics and Gynecology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
J Obstet Gynaecol. 2022 Jan;42(1):67-73. doi: 10.1080/01443615.2021.1877646. Epub 2021 May 3.
This retrospective study was performed to comparatively evaluate the diagnostic accuracies of three-dimensional ultrasonography (3D-US) and magnetic resonance imaging (MRI) for identification of Müllerian duct anomalies (MDAs). A total of 27 women with suspected MDAs underwent gynaecological examination, 2D-US, 3D-US and MRI, respectively. The MDAs were classified with respect to the European Society of Human Reproduction and Embryology-European Society for Gynaecological Endoscopy (ESHRE/ESGE) and American Society of Reproductive Medicine (ASRM) systems. Based on the ESHRE/ESGE classification, there was a discrepancy for only one patient between US and MRI. Thus, the concordance between US and MRI was 26/27 (96.3%). With respect to ASRM classification, there was a disagreement between MRI and 3D-US in three patients, thus the concordance between MRI and 3D-US was 24/27 (88.9%). To conclude, the 3D-US has a good level of agreement with MRI for recognition of MDAs.Impact Statement Müllerian duct anomalies (MDAs) are relatively common malformations of the female genital tract and they may adversely affect the reproductive potential. The establishment of accurate and timely diagnosis of these malformations is critical to overcome clinical consequences of MDAs. The concordance between US and MRI for diagnosis of MDAs based on ESHRE-ESGE classification and ASRM were 96.3% and 88.9%, respectively. These results indicate that 3D US has a satisfactory level of diagnostic accuracy for MDAs and it can be used in conjunction with MRI. Minimisation of diagnostic errors is important to improve reproductive outcome and to avoid unnecessary surgical interventions. Efforts must be spent to eliminate the discrepancies between the clinical and radiological diagnosis of MDAs. Further trials should be implemented for establishment and standardisation of radiological images for identification and classification of MDAs.
这项回顾性研究旨在比较三维超声（3D-US）和磁共振成像（MRI）在识别苗勒管畸形（MDAs）方面的诊断准确性。共 27 名疑似 MDA 的女性分别接受了妇科检查、2D-US、3D-US 和 MRI。根据欧洲人类生殖与胚胎学会-欧洲妇科内镜学会（ESHRE/ESGE）和美国生殖医学学会（ASRM）系统对 MDA 进行分类。根据 ESHRE/ESGE 分类，US 和 MRI 之间仅对一名患者存在差异。因此，US 和 MRI 之间的一致性为 26/27（96.3%）。根据 ASRM 分类，MRI 和 3D-US 在三名患者之间存在分歧，因此 MRI 和 3D-US 之间的一致性为 24/27（88.9%）。总之，3D-US 在识别 MDA 方面与 MRI 具有良好的一致性。
苗勒管畸形（MDAs）是女性生殖道较为常见的畸形，可能会对生殖潜能产生不利影响。准确、及时地诊断这些畸形对于克服 MDA 的临床后果至关重要。基于 ESHRE-ESGE 分类和 ASRM，US 和 MRI 对 MDA 的诊断一致性分别为 96.3%和 88.9%。这些结果表明，3D-US 对 MDA 具有令人满意的诊断准确性，可与 MRI 联合使用。减少诊断错误对于提高生殖结局和避免不必要的手术干预非常重要。必须努力消除 MDA 的临床和放射学诊断之间的差异。应进一步开展试验，为 MDA 的识别和分类建立和标准化放射学图像。
