Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography.

TLDR

The study compared the relative accuracy of magnetic resonance imaging, endovaginal sonography, and hysterosalpingography for classifying Müllerian duct anomalies in 26 patients. The cohort comprised 26 women, 24 with surgically confirmed anomalies and 2 with normal uteri (one vaginal septum). MR imaging correctly identified all 24 anomalies (100 % accuracy), EVS correctly identified 11 of 12 cases (92 % accuracy) and HSG only 4 of 20, with MR and EVS achieving 100 % sensitivity and specificity for septate uterus and non‑surgical anomalies, demonstrating that MR imaging and EVS can noninvasively differentiate uterine anomalies and avoid diagnostic laparoscopy.

Abstract

The purpose of this study was to compare the relative accuracy of magnetic resonance (MR) imaging (n = 26), endovaginal sonography (EVS) (n = 14), and hysterosalpingography (HSG) (n = 20) in the classification of müllerian duct anomalies in 26 patients. There were 24 cases of surgically proved anomaly, and two patients had normal uteri (one with a vaginal septum). MR imaging allowed diagnosis of 24 of 24 cases (accuracy, 100%), and EVS was correct in 11 of 12 cases (accuracy, 92%). HSG was correct in only four cases. In the diagnosis of septate uterus, MR imaging demonstrated a sensitivity and specificity of 100% and EVS demonstrated a sensitivity of 100% and a specificity of 80%. Both MR imaging and EVS demonstrated a sensitivity and specificity of 100% in distinguishing those anomalies that did not require surgery. The high accuracy of MR imaging and EVS permit noninvasive differentiation of uterine anomalies and can spare women diagnostic laparoscopy, promoting cost-effective diagnosis.