Abstract To investigate the ultrasonographic characteristics of uterine incision diverticulum (UID) inspected by transvaginal three-dimensional ultrasound (TTDU) after cesarean section, and to analyze its diagnostic value. Methods: The data of 350 women with suspected uterine incision diverticulum from October 2016 to December 2018 were collected retrospectively. The length, width, depth, thickness of incision muscle layer, shape of diverticulum (fissure liquid dark area, cystic liquid dark area, wedge liquid dark area) and other ultrasonographic features of UID of these women were observed by TTDU. And these women were divided in to group A and B according to the existence of clinical symptoms. The difference of sonographic features of women was observed between the two groups. Based on the result of diagnosd by hysteroscopy, the sensitivity and specificity of TTDU were analyzed. Results: There were 246 women with UID by TTDU, which included 103 women with clinical symptoms in group A and 143 women without clinical symptoms in group B. The length, width, depth, and incision myome thickness of UID of women in group A were 8.92±2.35 mm, 10.95±3.67mm, 5.87±1.79mm, and 3.25±1.03mm, respectively, which were significant higher than those of women in group B (P＜0.05). In group A, the rate of fissure-like dark areas (47.6%) of women was the main, but in group B, the rate of cystic and wedge-shaped liquid dark areas (93.20%) was the main (P＜0.05). The area under ROC curve (AUC) of UID by TTDU was 0.786 (95% CI: 0.6850.887, P=0.000), which’s sensitivity and specificity were 77.1% and 80.0%. Conclusion: TTDU used for diagnosing UID after cesarean section has high clinical value.
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