Detection of Congenital Mullerian Anomalies Using Real-Time 3D Sonography
نویسندگان
چکیده
A 35 year-old woman referred to Royan Institute (Reproductive Biomedicine Research Center) for infertility treatment. She had an eleven-year history of primary infertility with a normal abdominal ultrasound. Hysterosalpingography (HSG) was obtained one month prior to referral in another center (Fig A). The HSG finding of an apparent unicorn uterus followed by a normal vaginal ultrasound led us to perform a three-dimensional vaginal ultrasound before resorting to hysteroscopy. Results of the three-dimensional vaginal ultrasound revealed a normal uterus (Fig B, C). Accurate characterization of congenital Mullerian anomalies (MDAs) such as an arcuate, unicornuate, didelphys, bicornuate or septate uterus is challenging. While HSG has been the standard test in the diagnosis of MDAs, some limitations may favor the use of three-dimensional ultrasound. The most difficult part of HSG is interpreting the two-dimensional radiographic image into a complex, three-dimensional living organ (1). A variety of technical problems may occur while performing HSG. In this case, only an oblique view could lead to a correct interpretation. It is advisable for the interpreter to perform the procedure rather than to inspect only the finished radiographic images (2). One of the most useful scan planes obtained on three-dimensional ultrasound is the coronal view of the uterus. This view is known to be a valuable problem-solving tool that assists in differentiating between various types of MDAs due to the high level of agreement between three-dimensional ultrasound and HSG (3, 4). Recently, three-dimensional ultrasound has become the sole mandatory step in the initial investigation of MDAs due to its superiority to other techniques that have been used for the same purpose (5). Imaging in Reproductive Medicine
منابع مشابه
Detection of Congenital Mullerian Anomalies by Real-time 3D Sonography
ullerian duct anomalies (MDAs) are relatively common disorders that are particularly responsible for obstetrical complications and have a prevalence of about 3%−4% in the general population (1, 2). Uterine malformations may result from arrested development of the mullerian ducts, failure of fusion of the mullerian ducts or failure of resorption of the median septum (1, 2). Several classificatio...
متن کاملO-28: Detection of Fetal Major Structural Abnormalities with US in ART Patients during One Year
Background: The aims were to determine the diagnostic accuracy of ultrasound sonography in detecting major structural anomalies on all patients who conceived during a year of infertility treatment [assisted reproductive technology (ART) or non-ART treatments] at the Royan Institute, and to study the outcome of cases with nuchal translucency (NT) ≥ 95th centile in the first trimester of pregnanc...
متن کاملA study of the cost, accuracy, and benefits of 3-dimensional sonography compared with hysterosalpingography in women with uterine abnormalities.
OBJECTIVES We conducted a prospective blinded study to evaluate the costs, accuracy, risks, and benefits of 3-dimensional (3D) transvaginal sonography compared to hysterosalpingography. METHODS A total of 101 women aged 26 to 44 years with evidence of uterine anomalies were enrolled. All participants had routine hysterosalpingography as part of their infertility evaluation as well as 3D trans...
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Many debates surrounded the most appropriate approach of mullerian anomalies diagnosis. In congenital uterine anomalies 3D ultrasound is critical in reaching the correct diagnosis, by means of assessing the coronal plane of the uterus. Canalization defects reduce fertility and increase rates of miscarriage and preterm delivery. Unification defects seem to preserve fertility, but some are associ...
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