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Reproducibility of three‐dimensional ultrasound diagnosis of congenital uterine anomalies

R. Salim, B. Woelfer, M. Backos, L. Regan, D. Jurkovic

Ultrasound in Obstetrics and Gynecology · 2003 · 230 citations · 16 references

Open access

TL;DR

The study aimed to assess the reproducibility of diagnosing congenital uterine anomalies and the repeatability of uterine cavity measurements using three‑dimensional ultrasound. The authors re‑sliced stored 3D ultrasound volumes, had two independent observers evaluate standardized planes with Fallopian tube reference points, measured width, fundal distortion, and unaffected cavity length in 35 anomaly cases, and assessed intra‑ and inter‑observer variability across 83 volumes. The method classified 27 uteri as normal, 33 arcuate, 19 subseptate, and 3 unicornuate with a kappa of 0.97, showing intra‑observer limits of agreement of ±1.43–2.51 mm and no significant inter‑observer differences, confirming 3D ultrasound’s reproducibility for diagnosis and measurement.

Abstract

To examine the reproducibility of the diagnosis of congenital uterine anomalies and the repeatability of measurements of uterine cavity dimensions using three-dimensional (3D) ultrasound.The reproducibility of diagnosis of congenital uterine anomalies was examined by re-slicing stored 3D ultrasound volumes. Each data set was evaluated by two independent observers. Assessment of uterine morphology was performed in a standardized plane, with the interstitial portions of the Fallopian tubes used as reference points. Additionally, in 35 cases of congenital uterine anomalies the width of the uterine cavity (W), fundal distortion (F) and the length of unaffected uterine cavity (C) were measured. Intraobserver and interobserver variabilities were evaluated by each observer performing all three measurements twice.Eighty-three 3D ultrasound volumes were examined. Both operators classified 27 uteri as normal, 33 as arcuate, 19 as subseptate and three as unicornuate. A single case of uterine anomaly was described as arcuate uterus by one operator and subseptate by another (kappa 0.97). The intraobserver variability for each of the three measurements (W, F and C) was satisfactory with limits of agreement ranging from +/-1.43 to +/-2.51 mm. The examination of the interobserver variability showed no significant differences between the two observers (F = 0.484, P > 0.05).3D ultrasound is a reproducible method for the diagnosis of congenital uterine anomalies and for the measurement of uterine cavity dimensions.