Application of transvaginal three-dimensional ultrasound OmniView sonography in the diagnostic value of congenital uterine malformation and image analysis

Abstract

Objective To summarize the sonographic features and the diagnostic value of transvaginal three dimensional OmniView sonography for congenital uterine malformation. Methods Thirty-six patients who were suspected as uterus septus on transvaginal two-dimensionalultrasound (2D US) were examined by transvaginal three dimensional ultrasound (3D US) of OmniView. The coronal plane images were acquired. The fundus,cavity and cervix of the uterus were analyzed. The depths of fundal cleft were measured.In comparison with the test results of hysterosalpingography (HSG), hysteroscopy, hysteroscopy combined with laparoscope or magnetic resonance imaging (MRI), the sonographic features and the diagnostic value of transvaginal three dimensional OmniView sonography were summarized. Results Among the 36 cases underwent transvaginal three-dimensional ultrasound (3D US), 16 cases were diagnosed as incomplete septate uterus, 5 cases as complete septate uterus, 5 cases as arcuate uterus, 4 cases as bicornuate uterus, 4 cases as gemini and 2 cases as unicornuate uterus. The results of all 36 cases were confirmed by surgery or magnetic resonance imaging (MRI). The sonographic features of transvaginal three dimensional OmniView sonography: (1) Twenty-one septate uterus had convexes (in 12 cases) or minimally depressed fundus (in 9 cases, depth of cleft≤1.0 cm) and had Y-shaped (16 incomplete septate uterus without septum extending into cervix) or V-shaped cavity (5 complete septate uterus with septum extending into cervix). (2) Five arcuate uterus had an obtuse angle at the central point of septum. (3) Four bicornuate uterus had fundal depression more than 1.0 cm and were divided into two cornuas. (4) Four gemini had two complete uterus and cervix. (5) Two uterus unicornis had single endometrial and smaller than normal. Conclusions Transvaginal 3D OmniView sonopgraphy of uterine may display a good coronal plane, on which the relationship of the cavity and the fundus, the depth of fundal cleft and the angle at the central point of the septum can be well depicted and measured. It is a practical, reliable and noninvasive method, and superior to 2D US in the diagnostic classification of complex uterus malformation. Key words: Ultrasonography, three-dimensional; Diagnostic imaging; Uterus, congenital abnormalities