Comparison between 3D-Enhanced Conventional Pelvic Ultrasound and Magnetic Resonance Imaging in the Evaluation of Obstructive Müllerian Anomalies and Its Concordance with Surgical Diagnosis.

Abstract

Study objective: This study aimed to assess the practical application of conventional 2D pelvic ultrasound in conjunction with 3D ultrasound for evaluating obstructive Müllerian abnormalities.

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

Main outcome measures: 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 2 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 to be effective in diagnosis and was comparable to MRI.