Michele Marie Crockett MD, Abstract Co-Author: Nothing to Disclose

Sujata Vijay Ghate MD, Presenter: Nothing to Disclose

Brita K. Boyd MD, Abstract Co-Author: Consultant, General Electric Company

Erik Karl Paulson MD, Abstract Co-Author: Speakers Bureau, General Electric Company

To retrospectively determine the added value of 3D multiplanar ultrasonography to 2D sonohysterography.

Between Sept. 2003 and April 2005, 80 women (mean age 43.5 years, range 26-78) underwent sonohysterography (Voluson Expert, GE Healthcare) with both conventional 2D sonohysterography and 3D multiplanar imaging (volume of data was acquired and reconstructed in tranverse, sagittal, and coronal planes). Three independent, blinded readers interpreted the 2D scans alone, followed by 2D and 3D images together. Detection and characterization of any endometrial abnormality (polyps, fibroids, or septations), and definition of fundal contour was scored by each reader on a 3 point scale (1=present, 2=unsure, 3=absent). The signed rank test was used to assess mean differences between findings. Reader agreement was determined with the kappa statistic. Pathology correlation was performed when available.

Average reader scores (mean ± standard deviation) for identification of any endometrial abnormality were not significantly different, with scores of 1.70 ± 0.91 for 2D alone vs. 1.69 ± 0.92 for 2D + 3D combined (p=0.38). There was also no significant difference when polyps (2.14 ± 0.90 vs. 2.12 ± 0.93), fibroids (2.57 ± 0.79 vs. 2.53 ± 0.82), or septations (2.88 ± 0.39 vs. 2.87 ± 0.42) were evaluated separately. Average scores for fundal contour definition were significantly different with 2.93 ± 0.34 for 2D alone vs. 1.45 ± 0.80 for 2D + 3D combined (p<0.0001). Agreement between readers was demonstrated with average kappa of 0.72 for 2D alone, and 0.78 for 2D + 3D. In the 48 subjects for whom pathology was available, readers identified 90.2% of abnormalities.

3D combined with 2D transvaginal sonohysterography is not significantly different from 2D imaging alone for detection of endometrial abnormalities; however, 3D reformations do improve visualization of the uterine fundus and aid in identification or exclusion of a fundal contour abnormality.

Reconstructed 3D images in sonohysterography do not provide significant additional value in identifying endometrial abnormalities, but do add value in evaluating the fundal contour.

Crockett, M, Ghate, S, Boyd, B, Paulson, E, Sonohysterography: Do 3 Dimensional (3D) Reconstructed Images Provide Additional Value?.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4433048.html