Diagnostic Accuracy of 3D USG versus Hysterosalpingography Using MRI as Reference Standard for Müllerian Duct Anomalies

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Published: July 5, 2026 | Views: 126

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Authors

Revati Tekwani and Hemangini Thakkar

DOI Number
https://doi.org/10.15415/jmrh.2026.122003

Keywords
Müllerian duct anomalies, 3D ultrasonography, Hysterosalpingography, Infertility

Abstract

Background: Müllerian duct anomalies (MDAs) significantly contribute to infertility and lead to poor reproductive outcomes. However, MDAs are usually underdiagnosed. It is important to make an appropriate diagnosis of MDAs to treat infertility. Magnetic resonance imaging (MRI) is the gold standard for the diagnosis of MDAs. However, three-dimensional ultrasonography (3D USG) has become a promising diagnosis method for MDAs.

Purpose: The aim of the present study was to analyze the diagnostic accuracy of 3D USG in the diagnosis of MDAs.

Methods: A cross-sectional study was conducted in a tertiary care teaching hospital over 18 months. A total of 30 patients with suspected MDAs were included in the study. All patients underwent hysterosalpingography (HSG), 3D USG, and MRI. The diagnostic performance of HSG and 3D USG was evaluated. Agreement between different modalities was also analyzed.

Results: The most common anomalies were septate and subseptate uteruses, followed by arcuate, didelphys, and unicornuate uteruses. 3D USG demonstrated 100% sensitivity, specificity, PPV, NPV, and diagnostic accuracy, with perfect agreement with MRI (kappa = 1.00). HSG showed a sensitivity of 63.33% and an accuracy of 61.29%, with 8.33% NPV and moderate agreement with MRI (kappa = 0.51). HSG usually misclassified a septate uterus as bicornuate and failed to detect certain anomalies such as an accessory cavitated uterine mass.

Conclusion: 3D ultrasonography is a highly accurate, reliable, and non-invasive technique for diagnosing MDAs. It may serve as a first-line imaging tool, whereas HSG has limited diagnostic utility.

References

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How to Cite

Revati Tekwani and Hemangini Thakkar. Diagnostic Accuracy of 3D USG versus Hysterosalpingography Using MRI as Reference Standard for Müllerian Duct Anomalies. J. Multidiscip. Res. Healthcare. 2026, 12, 37-45

Diagnostic Accuracy of 3D USG versus Hysterosalpingography Using MRI as Reference Standard for Müllerian Duct Anomalies

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