Diagnostic Performance of Two-Dimensional Ultrasound, Two-Dimensional Sonohysterography and Three-Dimensional Ultrasound in the Diagnosis of Septate Uterus-A Systematic Review and Meta-Analysis
Juan Luis Alcázar 1 , Isabel Carriles 1 , María Belén Cajas 2 , Susana Costa 3 , Sofia Fabra 4 , Maria Cabrero 2 , Elena Castro 5 , Aida Tomaizeh 6 , María Victoria Laza 7 , Alba Monroy 7 , Irene Martinez 6 , Maria Isabel Aguilar 6 , Elena Hernani 8 , Cristina Castellet 9 , Agustin Oliva 10 , María Ángela Pascual 9 , Stefano Guerriero 11 12
Background: The septate uterus is the most common congenital uterine anomaly, and hysteroscopy is the gold standard for diagnosing it. The goal of this meta-analysis is to perform a pooled analysis of the diagnostic performance of two-dimensional transvaginal ultrasonography, two-dimensional transvaginal sonohysterography, three-dimensional transvaginal ultrasound, and three-dimensional transvaginal sonohysterography for the diagnosis of the septate uterus.
Methods: Studies published between 1990 and 2022 were searched in PubMed, Scopus, and Web of Science. From 897 citations, we selected eighteen studies to include in this meta-analysis.
Results: The mean prevalence of uterine septum in this meta-analysis was 27.8%. Pooled sensitivity and specificity were 83% and 99% for two-dimensional transvaginal ultrasonography (ten studies), 94% and 100% for two-dimensional transvaginal sonohysterography (eight studies), and 98% and 100% for three-dimensional transvaginal ultrasound (seven articles), respectively. The diagnostic accuracy of three-dimensional transvaginal sonohysterography was only described in two studies, and we did not calculate the pooled sensitivity and specificity for this method.
Conclusion: Three-dimensional transvaginal ultrasound has the best performance capacity for the diagnosis of the septate uterus.
CITATION Diagnostics (Basel). 2023 Feb 20;13(4):807. doi: 10.3390/diagnostics13040807