Comparison of transvaginal sonography and saline contrast sonohysterography in women with abnormal uterine bleeding: correlation with hysteroscopy and histopathology.
نویسندگان
چکیده
BACKGROUND Transvaginal ultrasound is used conventionally as initial investigation of patients with abnormal uterine bleeding but saline contrast sonohysterography is a better technique to reliably distinguish focal from diffuse endometrial lesions. This study was performed to compare the ability of transvaginal ultrasonography and saline infusion sonohysterography as initial modality for the diagnosis of endometrial abnormalities in women with abnormal uterine bleeding. PATIENTS AND METHODS In a prospective study, 100 women with abnormal uterine bleeding were submitted to sequential examination by transvaginal ultrasound, and sonohysterography. The presence of focal endometrial lesions and the type of lesion (endometrial hyperplasia, polyp, submucous myoma, or malignancy) were noted. Predictive values were calculated by correlating the results with final diagnosis reached by hysteroscopy and endometrial biopsy. RESULTS The sonohysterography had 92.9% sensitivity and 89.7% specificity compared to 71.4% sensitivity and 67.7% specificity achieved by transvaginal sonography. There was 91% agreement between saline contrast sonohysterography and hysteroscopy as compared to 69% for TVS (p = 0.002). The diagnostic performance of sonohysterography for 3 main endometrial abnormalities (i.e. endometrial hyperplasia, polyps and submucous myoma) was better than transvaginal sonography. The best results were seen in cases of submucous myoma where sensitivity and specificity of sonohysterography reached to 100% as compared to TVS (61.55 and 97.7% respectively). CONCLUSION Our results have substantiated that sonohysterography is a better tool than transvaginal sonography for the assessment of endometrial intra-cavity lesions. By providing accurate differentiation between focal and diffuse endometrial lesions, it can help in decision making regarding selection of cases for hysteroscopy and directed biopsy. We recommend that saline contrast sonohysterography should be used as an initial investigation in cases of abnormal uterine bleeding.
منابع مشابه
Comparison of sonography, sonohysterography, and hysteroscopy for evaluation of abnormal uterine bleeding.
We compared transvaginal sonography, sonohysterography, and diagnostic hysteroscopy in the evaluation of abnormal uterine bleeding, Sixty-eight women 40 or older with abnormal uterine bleeding were assigned to undergo either transvaginal sonography or sonohysterography. All subjects then had diagnostic hysteroscopy and endometrial biopsy. Patients with abnormal findings underwent operative hyst...
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Background Abnormal uterine bleeding (AUB) is one of the most common clinical problems in gynecology. Transvaginal sonography (TVS) and hysteroscopy are two diagnostic methods for patients with AUB. For most of the patients with AUB, diagnostic hysteroscopy can be done in clinic with minimal discomfort and much lower expense than operative room. MaterialsAndMethods In our clinical trial study, ...
متن کاملI-34: Comparison between Hysteroscopy and Sonohysterography in Uterine Cavity Assessment
Intrauterine pathologies have been shown to be present in 25% of infertile patients.Structural abnormalities of the uterine endometrial cavity may affect the reproductive outcome adversely, by interfering with the implantation or causing spontaneous abortion. Intrauterine abnormalities may visualize using a variety of techniques. Including hysterosalpingography (HSG), transvaginal sonography (T...
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متن کاملAssessment of transvaginal ultrasonography accuracy in the diagnosis of uterine pathologies in women with abnormal uterine bleeding
Abstract Background: The most common causes of abnormal uterine bleeding in women of reproductive age are uterine structural abnormalities. There are several modalities for the examination of abnormal uterine bleeding, including transvaginal ultrasound and hysteroscopy. In this study, we aimed to investigate the diagnostic accuracy of hysteroscopy versus transvaginal ultrasound in the diagnosis...
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ورودعنوان ژورنال:
- International journal of health sciences
دوره 1 1 شماره
صفحات -
تاریخ انتشار 2007