When comparing diagnostic modalities to hysterectomy for the detection of intracavitary abnormalities, MRI, SIS, and hysteroscopy were equally effective and superior to TVUS [76]. US Pelvis Color Doppler Power Doppler has been shown to be useful in detecting stalks within endometrial polyps and peripheral or rim vascularity in submucosal fibroids [77]. Color Doppler has also been shown to be useful in differentiating the central vascular pattern of adenomyosis from the peripheral vascularity of fibroids [78]. This procedure is not performed in isolation but in conjunction with TVUS. US Pelvis Transvaginal On both TVUS and MRI, an external fundal cleft >1 cm can be used to diagnose a bicornuate uterus and differentiate it from a septate uterus (fundal cleft <1 cm) [67]. A fundal indentation <5 mm above the interostial line can also be used for identification of a bicornuate uterus [74]. In 24 cases of surgically proven MDA, MRI was 100% accurate, 2-D TVUS was 92% accurate, and hysterosalpingogram was only 16.7% accurate [67]. For detecting intrauterine adhesions, a study of 19 women showed that HSG and sonohysterography were both 100% sensitive, and conventional TVUS was only 52% sensitive compared with hysteroscopy [69]. In another study of 133 women undergoing infertility evaluation who underwent both hysteroscopy and TVUS, TVUS detected submucosal fibroids in 10 of the 11 patients diagnosed with submucosal fibroids at hysteroscopy, yielding a sensitivity of 91% and specificity of 100% [79]. When comparing diagnostic modalities with hysterectomy for the detection of intracavitary abnormalities, MRI, SIS, and hysteroscopy were equally effective and superior to TVUS [76]. US Sonohysterography Contrast sonohysterography or SIS provides an assessment of the uterine cavity. Although the endometrium can be assessed by TVUS, SIS is particularly useful in assessing potential causes of infertility, including intrauterine adhesions, endometrial polyps, and leiomyomas [52].
Female Infertility. When comparing diagnostic modalities to hysterectomy for the detection of intracavitary abnormalities, MRI, SIS, and hysteroscopy were equally effective and superior to TVUS [76]. US Pelvis Color Doppler Power Doppler has been shown to be useful in detecting stalks within endometrial polyps and peripheral or rim vascularity in submucosal fibroids [77]. Color Doppler has also been shown to be useful in differentiating the central vascular pattern of adenomyosis from the peripheral vascularity of fibroids [78]. This procedure is not performed in isolation but in conjunction with TVUS. US Pelvis Transvaginal On both TVUS and MRI, an external fundal cleft >1 cm can be used to diagnose a bicornuate uterus and differentiate it from a septate uterus (fundal cleft <1 cm) [67]. A fundal indentation <5 mm above the interostial line can also be used for identification of a bicornuate uterus [74]. In 24 cases of surgically proven MDA, MRI was 100% accurate, 2-D TVUS was 92% accurate, and hysterosalpingogram was only 16.7% accurate [67]. For detecting intrauterine adhesions, a study of 19 women showed that HSG and sonohysterography were both 100% sensitive, and conventional TVUS was only 52% sensitive compared with hysteroscopy [69]. In another study of 133 women undergoing infertility evaluation who underwent both hysteroscopy and TVUS, TVUS detected submucosal fibroids in 10 of the 11 patients diagnosed with submucosal fibroids at hysteroscopy, yielding a sensitivity of 91% and specificity of 100% [79]. When comparing diagnostic modalities with hysterectomy for the detection of intracavitary abnormalities, MRI, SIS, and hysteroscopy were equally effective and superior to TVUS [76]. US Sonohysterography Contrast sonohysterography or SIS provides an assessment of the uterine cavity. Although the endometrium can be assessed by TVUS, SIS is particularly useful in assessing potential causes of infertility, including intrauterine adhesions, endometrial polyps, and leiomyomas [52].