The Comparison between Three-dimensional enhanced Conventional Pelvic Ultrasound and Magnetic Resonance Imaging in the Evaluation of Obstructive Müllerian Anomalies and its Concordance with Surgical Diagnosis.

Abstract

Objectives: This study aimed to assess the practical application of conventional two-dimensional (2D) pelvic ultrasound in conjunction with three-dimensional (3D) ultrasound for evaluating obstructive Müllerian abnormalities.

Design: Respective study in tertiary referral hospital METHOD: Computerized stored data was used to collect surgical confirmed obstructive Müllerian anomalies cases between December 2022 and October 2023 with presurgical imagings being evaluated. Acute presentation with abdominal pain and clinical suspicion of obstructive Müllerian abnormality were required for inclusion. All study participants underwent pelvic ultrasound prior to the definitive surgery, with or without a repeat MRI if one was performed previous to admission. Those situations where both MRI and ultrasound were not conducted were excluded, such as the transverse vaginal septum, imperforate hymen, iatrogenic cervical injury or Müllerian malformation alone without obstructive outflow anomalies like didelphys, bicornuate, or septate uterus.

Main outcomes measures: The concordance between the surgically confirmed diagnosis and the pelvic ultrasound was reported in 27 of 29 women (93.1%). In contrast, only 24 of 29 cases were correctly diagnosed with MRI in this study (82.8%). This pilot study presents a comparison of two techniques, with a specific focus on obstructive Müllerian anomalies. The use of pelvic ultrasound not only assisted in our surgical practice but also significantly improved patient-doctor counseling.

Conclusion: In managing obstructive Müllerian abnormalities, 3D-enhanced conventional pelvic ultrasound was found effective in diagnosis and was comparable to MRI.