The diagnostic accuracy of two- vs three-dimensional sonohysterography for evaluation of the uterine cavity in the reproductive age.

STUDY OBJECTIVE: To compare 2-dimensional sonohysterography (2D SHG) vs 3-dimensional sonohysterography (3D SHG) using saline solution infusion, with outpatient hysteroscopy as the gold standard, for evaluation of the uterine cavity in women of reproductive age.

DESIGN: Comparative observational cross-sectional study (Canadian Task Force classification II-2).

SETTING: University hospital.

PATIENTS: One hundred twenty women of reproductive age with abnormal uterine bleeding, infertility, or recurrent pregnancy loss and with clinically and/or ultrasongraphically suspected intrauterine lesions.

INTERVENTIONS: All patients underwent 2D SHG and 3D SHG using saline solution infusion followed by outpatient hysteroscopy. Sonographic findings were compared with hysteroscopic findings.

MEASUREMENTS AND MAIN RESULTS: For 2D SHG, sensitivity was 71.2%; specificity, 94.1%; positive predictive value, 90.2%; negative predictive value, 81.0%; and overall accuracy, 84.2%. For 3D SHG, sensitivity was 94.2%; specificity, 98.5%; positive predictive value, 98.0%; negative predictive value, 95.7%; and overall accuracy, 96.7%. Thus, 3D SHG was superior to 2D SHG (p = .02) and comparable with outpatient hysteroscopy (p = .12) for diagnosis of intrauterine lesions.

CONCLUSION: 3D SHG can be used in the initial evaluation of the uterine cavity in women of reproductive age, with accuracy comparable to that of hysteroscopy.