3D Transvaginal Ultrasound as Differential Diagnosis of Severe Intrauterine Adhesions

A recent study aimed to develop and validate a nomogram for differentiating severe intrauterine adhesions (IUAs) from mild-to-moderate IUAs preoperatively based on three-dimensional transvaginal ultrasound (3D-TVUS). The findings of the study are published in Journal of Minimally Invasive Gynecology JMIG.

Retrospective observational study of total of 212 patients with mild-to-moderate IUAs and 201 patients with severe IUAs were enrolled. Intercornual distance, endometrial thickness, number of visible fallopian tubal ostia, echoes of the endometrial-myometrial junction zone, and endometrial blood flow grade differed significantly between the severe and mild-to-moderate IUAs groups.

The study found that the area under the receiver operating characteristic curve of the nomogram was 0.880 (95% CI: 0.843–0.918) in the training set and 0.878 (95% CI: 0.818–0.939) in the validation set, revealing reliable discrimination. The calibration curve and Hosmer–Lemeshow test showed strong calibration, and decision curve analysis indicated that the nomogram had a high net benefit and a wide range of threshold probabilities.

Researchers concluded that this nomogram, which was developed based on three-dimensional transvaginal ultrasound (3D-TVUS), can accurately distinguish severe intrauterine adhesions from mild- to-moderate intrauterine adhesions preoperatively.