To evaluate the diagnostic value of three-dimensional ultrasound for uterine cavity lesions in infertile patients.

Infertility patients who underwent three-dimensional ultrasound from January 2017 to December 2018 at the First Affiliated Hospital of Nanjing Medical University were collected. Three-dimensional ultrasound results of 428 patients diagnosed with different types of uterine cavity lesions were compared with those of hysteroscopy or histopathology. The four grid table was used to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of three-dimensional sonography.

Three-dimensional ultrasound detected uterine cavity lesions in 428 patients, including 235 (54.9%) cases of intrauterine adhesion, 153 (35.7%) cases of endometrial polyps, and 40 (9.4%) cases of submucosal myoma. Compared with hysteroscopy or histopathology results, the three-dimensional ultrasound had consistent results in 404 cases (94.4%), and 24 (5.6%) cases were misdiagnosed, of which 14 were misdiagnosed as intrauterine adhesions, 7 misdiagnosed as endometrial polyp, and 3 as submucosal myoma. The accuracy of three-dimensional ultrasonography in diagnosing various types of uterine cavity lesions was 96.73% for intrauterine adhesion, 96.96% for endometrial polyps, and 98.83% for submucosal myoma.

Three-dimensional ultrasound has a high diagnostic accuracy for various types of uterine cavity lesions, which can be used as the first choice for infertile patients to exclude uterine cavity lesions.