OC29.02: How to diagnose a t‐shaped uterus by 3D‐TVS criteria: a comparative study

To evaluate the lateral (L) and the antero-posterior (AP) uterine wall thickness and their ratio (L/AP) by 3D-TVS in fertile women with an ESHRE - ESGE normal (class U0), t-shaped (class U1a) and septate uterus (class U2). Consecutive fertile patients with t-shaped and septate uterus were recruited and compared to a control group (normal uterus). Patients with myomas and/or adenomyosis were excluded. 3D-TVS was performed by the GE Voluson E8 unit, using a wide-band 3-9 MHz transducer. Compound Resolution Imaging (CRI) and Speckle Reduction Imaging (SRI) technologies were used to optimise image before volume acquisition by enhancing contrast resolution and reducing artifacts and speckle. Volume Contrast Imaging (VCI) analysis (by two millimeters slices) of the stored 3D multiplanar examination was considered for the evaluation of the L, AP and L/AP on the sagittal and coronal planes. The uterine wall thickness was measured at its thickest in the orthogonal planes. 170 enrolled patients were considered (66, 56 and 48 class U0, U1a and U2 patients, respectively). Mean age was 34 years (SD ± 7). Mean L thickness was significantly thicker in the T-shaped compared to the normal and the septate groups (18.4 ± 1.6mm, 12.5 ± 1.7mm and 12.3 ± 1.2mm, respectively). Mean AP was significantly different in the three groups (normal: 12.7 ± 1.6mm; T-shaped 13.1 ± 1.6mm; septate11.4 ± 1.2mm). Mean L/AP ratio was significantly different in the three groups (normal: 1.03 ± 0.2mm; T-shaped 1.42 ± 0.2mm; septate1.09 ± 0.1mm). 3D-TVS by VCI analysis can permit to properly evaluate the lateral and the anteroposterior uterine wall thickness in the three orthogonal planes. The lateral uterine wall thickness > 17mm and the lateral/anteroposterior uterine wall thickness ratio > 1.4 should be considered proper criteria to diagnose a t-shaped uterus.