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DIAGNOSTIC ACCURACY OF 3D TRANSVAGINAL ULTRASOUND FOR UTERINE CAVITARY PATHOLOGIES IN INFERTILITY: A HYSTEROSCOPY- REFERENCED STUDY
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Abstract
Purpose: To quantify the diagnostic accuracy of 3D transvaginal US for detecting uterine cavity pathology in infertile women, using hysteroscopy as the reference standard. Materials and Methods: In this single‑center cross‑sectional study (Vinmec Times City International Hospital; January 2017–March 2018), 48 women with infertility underwent 3D transvaginal US followed by hysteroscopy. Patient‑level sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed- using hysteroscopy as the reference standard. Results: Hysteroscopy was completed in all 48 patients and demonstrated abnormalities in 17/48 (35,4%). For detection of the composite outcome uterine cavity abnormalities, 3D transvaginal US yielded sensitivity 82,4%, specificity 93,5%, PPV 87,5%, and NPV 90,6%. For endometrial polyps detection, 3D transvaginal US achived sensitivity 80,0%, specificity 100,0%, PPV 100,0%, and NPV 95,0%. Conclusion: In this cohort, 3D transvaginal US demonstrated high specificity and strong rule‑out performance for cavitary pathology, with perfect specificity and PPV for endometrial polyp detection. These results support broader implementation of 3D transvaginal ultrasound to detect cavitary uterine abnormalities prior to embryo transfer in the management of infertility, given its high diagnostic performance.
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Keywords
Three dimensional transvaginal ultrasound; Hysteroscopy; Endometrial polyp; Infertility; Sensitivity and specificity.
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