3D Ultrasound Assessment of the Uterus: Why an Accuracy Study for Mullerian Congenital Anomalies is not Feasible, while Screening Already is, and should be done

Abstract

The review covers the recently published research regarding the assessment of congenital mullerian anomalies by means of 3-dimensional transvaginal ultrasound. It is a plea toward standardization, defining diagnostic criteria, specifying the diagnostic methods and screening on daily basis with 3D ultrasound for congenital uterine anomalies. Many debates surrounded the most appropriate approach of mullerian anomalies diagnosis. In congenital uterine anomalies 3D ultrasound is critical in reaching the correct diagnosis. Before the routine use of 3D scanning for uterine anomalies is recommended, research should be dedicated to reproducibility of the diagnosis of uterine abnormalities. “Volumetric criteria” for the diagnosis of female genital anomalies should probably be elaborated, because we still face the lack of agreement in regards to diagnostic standards. There is very limited information on the reproductive risk associated with an incidental diagnosis of congenital uterine anomaly and the true prevalence in general population in not known. In order to achieve this objective, a relatively large amount of data needs to be collected. Uterine anomalies being rare, this can only be achieved by establishing a wide international collaboration involving a large number of research centers. 3D ultrasound is the only diagnostic method available to facilitate such collaboration. By submitting the archived 3D volumes, the operator dependence, the subjective bias in the assessment of uterine morphology and the selection bias would be almost completely eliminated. 3D ultrasound represents the most major development in gynaecological ultrasound imaging, providing a unique, very different way of displaying ultrasound data.