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Which Patients Benefit from a 3D Reconstructed Coronal View of the Uterus Added to Standard Routine 2D Pelvic Sonography?

¹ Diagnostic Ultrasound Associates, 333 Longwood Ave., Boston, MA 02115.
² Departments of Radiology, Brigham and Women's Hospital, Massachusetts General Hospital, and Harvard Medical School, Boston, MA.
³ Departments of Obstetrics and Gynecology, Brigham and Women's Hospital, Massachusetts General Hospital, and Harvard Medical School, Boston, MA.

OBJECTIVE. The objective of our study was to evaluate whether a 3D reconstructed coronal view of the uterus provides added benefit to standard gynecologic sonography.

MATERIALS AND METHODS. Sixty-six consecutive patients underwent standard 2D pelvic sonography followed by 3D sonography. The physician determined whether the reconstructed coronal view of the uterus was helpful to make a diagnosis not possible with the 2D scan, helpful to be more confident of a diagnosis suspected on the basis of the 2D scan, or not helpful. Comparison of the demographic information, sonographic findings, and endometrial thickness was made between the patient groups.

RESULTS. The 3D coronal views of the uterus added value to the 2D scan in 16 (24%) of the 66 patients. In five of these 16 patients, the coronal view added information about findings not seen using 2D imaging. In the other 11 patients, the diagnostic findings were more confidently seen using the coronal view. The coronal view added no information in 50 patients. The coronal view was helpful in four (12.5%) of 32 patients with an endometrium < 5 mm, one of six patients whose endometrium was incompletely seen with 2D sonography, and 11 (39%) of 28 patients whose endometrium measured 5 mm. The coronal view did not provide benefit in patients who had normal findings on 2D scanning. In three patients referred because of infertility, uterine shape anomalies were diagnosed using the coronal view.

CONCLUSION. The 3D coronal view of the uterus is a valuable adjunct to a 2D pelvic scan, particularly in patients presenting with infertility or suspected endometrial lesions. In addition, the coronal view is helpful in patients with an endometrium 5 mm.

Keywords: 3D sonography • infertility • obstetrics and gynecology • pelvic sonography • women's imaging

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