3D Transvaginal Ultrasound.

Three-dimensional (3D) transvaginal ultrasound (TVUS) has revolutionized gynecological imaging by providing enhanced visualization of pelvic structures with remarkable detail and accuracy. This advanced imaging modality has become an indispensable tool in the diagnosis and management of various gynecological conditions, including Müllerian anomalies, endometrial polyps, adenomyosis, and submucosal fibroids. By offering multiplanar views and volumetric reconstruction, 3D TVUS allows clinicians to assess the uterine cavity, myometrium, and surrounding structures with unprecedented precision.

1. Müllerian Anomalies:
   Müllerian duct anomalies (MDAs) are congenital malformations of the female reproductive tract that can lead to infertility, recurrent pregnancy loss, or obstetric complications. 3D TVUS provides a non-invasive method to evaluate the uterine architecture, including the external contour and internal cavity. It is particularly useful in classifying anomalies such as septate, bicornuate, or didelphys uteri, enabling tailored surgical planning and improved patient outcomes.

2. Endometrial Polyps:
   Endometrial polyps are benign growths within the uterine cavity that can cause abnormal uterine bleeding or infertility. 3D TVUS enhances the detection of these lesions by providing a comprehensive view of the endometrium. The coronal plane, unique to 3D imaging, allows for precise localization and measurement of polyps, aiding in preoperative planning and guiding hysteroscopic resection.

3. Adenomyosis:
   Adenomyosis, characterized by the presence of endometrial tissue within the myometrium, is often challenging to diagnose due to its diffuse nature. 3D TVUS improves diagnostic accuracy by visualizing myometrial heterogeneity, cystic spaces, and the junctional zone. This modality helps differentiate adenomyosis from other conditions like fibroids, facilitating appropriate management strategies.

4. Submucosal Fibroids:
   Submucosal fibroids are a common cause of heavy menstrual bleeding and infertility. 3D TVUS provides detailed information about the size, location, and degree of intracavitary extension of these fibroids. This information is critical for determining the feasibility of hysteroscopic resection and predicting surgical outcomes.