Comparison of three-dimensional ultrasonography and diagnostic hysteroscopy in differential diagnosis of uterine malformations and uterine myomas

AIM: The aim of the study was to compare the diagnostic accuracy between 3D transvaginal sonography (3D-TVS) versus hysteroscopy (HYS) to evaluate uterine malformations and uterine fibroids. Magnetic Resonance Imaging (MRI) was used as gold-standard. METHODS: Ninety-six patients were enrolled. These presented with suspicious uterine cavity pathology. Women consecutively underwent to 3D-TVS, MRI and Hys by three different operators. RESULTS: 3D-TVS shows excellent sensitivity (95,3%) and specificity (90,9%) in uterine myomas detection, and exceptional sensitivity (90,9%) and specificity (100%) and PPV (100%) in the diagnosis of uterine malformations. Hysteroscopy appeared to have strong sensitivity (90,4%) and specificity (100%) and PPV (100%) in uterine myomas detection, and exceptional sensitivity (100%) and specificity (90,4%) in the diagnosis of uterine malformations. Both showed high accuracy (93,7%) in myomas detection, 3D-TVS had a slightly higher accuracy in the diagnosis of uterine malformations (96,8% vs 93,7%). CONCLUSION: 3D-TVS shows a good value in a primary assessment of uterine myomas and malformations for excluding uterine pathologies and confirming their presence, and could be used to avoid unnecessary diagnostic Hysteroscopies in healthy women, and could be helpful, after diagnostic hysteroscopy, to assess the pathologies of uterine wall, in the differential diagnosis of uterine septum and bicornuate uteri.