Congenital Mullerian anomalies: Diagnostic accuracy of three-dimensional ultrasound

Objective: To determine whether it is possible to identify and diagnose accurately Mullerian 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 Mullerian 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 Miillerian anomaly in all cases and came up with the correct classification in 11 of 12 cases. AU patients with a normal uterus were identified correctly. Conclusions: In all patients with Mullerian 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 Mullerian anomalies.