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Document Details :

Title: Diagnostiek van congenitale uteriene afwijkingen
Journal: Tijdschrift voor Geneeskunde
Volume: 70    Issue: 4   Date: 2014   
Pages: 203-205
DOI: 10.2143/TVG.70.04.2001558

Abstract :
De diagnostiek van congenitale uteriene afwijkingen vereist zowel een degelijk classificatiesysteem als accurate methoden om de correcte diagnose te stellen. De huidige wildgroei aan classificatiesystemen is toe aan een update gebaseerd op moderne diagnosemiddelen zoals een laparoscopie, een echografie, een MRI en een CT-scan. De recent in gebruik genomen 3D-echografie blijkt hier even accuraat als een MRI.

Diagnosis of congenital uterine anomalies
To classify congenital anomalies, a large number of classification systems have been proposed, of which the classification of the American Fertility Society (AFS) is most commonly used. The new classification of Acién takes the etiopathology, the anatomical anomalies and the clinic into account.
Several modalities may be used to diagnose uterine anomalies, but an ultrasound (3D if possible) and an MRI are most accurate and objective. A laparoscopy in combination with a hysteroscopy is more subjective, but can also be therapeutic.
An MRI is superior to an ultrasound to diagnose cervical or vaginal anomalies.
A recent study shows that an assessment of three-dimensional ultrasound images of congenital uterine anomalies has a substantial interobserver variability. The largest variability was found between the bicornuate uterus, the septate uterus and the uterus didelphys. The diagnoses, however, also differed between an arcuate and a normal uterus. Therefore, better definitions are needed to distinguish between the different types of uteri.

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