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VP59.42: The value of three‐dimensional transvaginal ultrasound imaging in the diagnosis of uterine horn pregnancy and tubal interstitial pregnancy

Objectives: To estimate the value of three-dimensional transvaginal ultrasound (3D-TVS) in detecting uterine horn pregnancy (UHP) and tubal interstitial pregnancy (TIP). Methods: 22 patients underwent 3D-TVS examination and were diagnosed as suspected UHP (n = 15) or TIP (n = 7). The diagnosis accuracy of 3D-TVS was calculated based on the outcome of surgery and pathology. The thickness of myometrium, which showed up around the gestational sac or mass (GSoM), was measured and then compared between UHP patients and TIP patients by using two sided t-test. The sonographic feature of each subject was observed by the coronal plane of 3D-TVS. Results: The diagnosis accuracy of 3D-TVS was 90.91% (20/22) showing a high consistency to the results of surgery and pathology (k = 0.811, p < 0.001). The diagnosis accuracy of UHP by using 3D-TVS was 86.67% (misdiagnosis rate was 13.33%) with image features of asymmetric uterine horns enlargement (100%), a GSoM in the bulged uterine horn (100%), a connection of GSoM to endometrium (100%). The diagnosis accuracy of TIP by using 3D-TVS was 87.50% (misdiagnosis rate was 12.50%) with image features of symmetric uterine horns (100%), connection of GSoM to endometrium (12.50%). The myometrium thickness around GSoM of UHP patients were (5.72 ± 1.08) mm, which is significantly thicker than those of TIP patients ((1.73 ± 0.84) mm) (p <0.001). Conclusions: The 3D-TVS imaging showed a high diagnostic accuracy in detecting UHP and TIP. Furthermore, with sonographic features observed by coronal plane of 3D-TVS, UHP and TIP could be differentiated.