EP27.07: Normal/arcuate vs septate uterus: diagnostic test accuracy and best cut‐off values for currently used measurements
Year: 2017
Type: article
Study design: Observational Study
Abstract: To assess the diagnostic test accuracy of measurements suggested by ESHRE/ESGE and ASRM for distinguishing between normal/arcuate and septate uterus using experts' opinion as reference standard. We included 100 women evaluated between Jun-2016 and Jul-2016 with suspected uterine anomaly. The images of the coronal plane of these uteri were submitted to 15 experts for distinguishing between normal/arcuate (normal uterine morphology or degree of distortion caused by the internal indentation is not clinically relevant) and septate uterus (the degree of distortion caused by the internal indentation is clinically relevant). Two observers (>10y experience with 3D-ultrasound), blinded to each other results and to the opinion of the experts, measured the indentation depth, indentation angle, and indentation to wall thickness (I:WT) ratio. The average value was used to assess the area under ROC curve (AUROC) and the best cut-off values using Youden's index. There were 18 septate and 82 normal/arcuate uteri based on the experts' opinion. The diagnostic test accuracy of the three measurements was very good: AUROC=1.00/0.96/0.99, 95%CI=0.96-1.00/0.90-0.99/0.94-1.00; indentation depth, indentation angle and I:WT ratio respectively. The best cut-off values were: indentation depth ≥10mm, indentation angle ≤136°, and I:WT ratio ≥110%. All the three measurements have good diagnostic test accuracy for distinguishing between normal/arcuate and septate uterus. However, the suggested cut-off values for indentation angle (<90° by ASRM) and for I:WT ratio (>50% by ESHRE-ESGE) should be revised.
DOI: 10.1002/uog.18759
Institutions: Jagiellonian University, Universidade de São Paulo, Hospital Universitari Sant Joan D'Alacant, Universidad de Navarra, Harvard University, The University of Sydney, Nepean Hospital, Carl von Ossietzky Universität Oldenburg, Spaarne Ziekenhuis, Baylor College of Medicine, University of Cagliari, Duke University, Duke Medical Center, Beth Israel Deaconess Medical Center, Wright State University, Valencian Infertility Institute, University of Florence, University College Hospital
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2754043746