Congenital Müllerian anomalies: diagnostic accuracy of three-dimensional ultrasound.

OBJECTIVE

To determine whether it is possible to identify and diagnose accurately Müllerian anomalies with three-dimensional (3-D) ultrasound (US).

DESIGN

Controlled blinded clinical study.

SETTING

Normal human volunteers undergoing infertility evaluation in a university hospital.

PATIENTS

Forty-two patients who underwent laparoscopy and hysterosalpingography as part of their work up for infertility and were found to have either a normal uterus (30 patients) or a Müllerian abnormality (12 patients) consented to be evaluated with 3-D US by sonographers who were unaware of their infertility history or of their laparoscopy and hysterosalpingography diagnoses.

INTERVENTIONS

Transvaginal 3-D US evaluation over a 10- to 15-minute duration.

MAIN OUTCOME MEASURES

Three-dimensional imaging was successful in all cases.

RESULTS

Sonographers identified a Müllerian anomaly in all cases and came up with the correct classification in 11 of 12 cases. All patients with a normal uterus were identified correctly.

CONCLUSIONS

In all patients with Müllerian anomalies, 3-D US examination of the endometrial cavity correlated with hysterosalpingography. In 91.6% of patients, 3-D US correlated with the external uterine configuration observed by laparoscopy. This technique may be used reliably in an office setting to diagnose and classify Müllerian anomalies.