Korean J Obstet Gynecol.  2006 Mar;49(3):653-659.

Clinical Usefulness of Transvaginal sonography and sonohysterography in evaluation of endometrial abnormalities

• Hong JS
• Song MS
• Lim JY
• Lee HJ
• Ahn KY
• Hong JS
• Kim JM
• Yeon JB
• Joo KY
• Choi KH

Abstract

OBJECTIVE
The aim of our study is to evaluate the clinical usefulness of transvaginal sonography (TVS) and saline infusion sonohysterography (SHG) in the evaluation of endometrial abnormality.
METHODS
We retrospectively reviewed 370 patients with abnormal uterine bleeding or uterine cavity abnormalities confirmed by TVS. SHG was carried out by experienced gynecologist, on the same setting in an outpatient clinic after the performance of TVS. Two hundred nineteen patients aged between 23 and 69 years (mean age 41+/-8.2) had operative hysteroscopy (88.2%), hysterectomy (9.1%) and dilatation/curettage (2.7%) within 3 months which provided a detailed description of uterine cavity. Surgical-pathologic findings were compared with the results obtained from TVS and SHG.
RESULTS
The sensitivity and specificity were 71.7% and 31.4% for TVS, and 98.4% and 67.6% for SHG respectively. The positive and negative predictive values were 84.6% and 17.5% for TVS, and 94.3% and 92.3% for SHG, respectively. Twenty one cases showed a discrepancy between the TVS and SHG, and 16 cases showed a discrepancy between SHG and the pathologic diagnosis. Fifty five cases (25%) in TVS were unconfirmed, but SHG showed 51 pathologic confirmed intracavitary lesion.
CONCLUSION
SHG is a sensitive tool and is superior to TVS used alone for evaluation of endometrial abnormalities. SHG definitely enhances the diagnostic potential of TVS in assessment of endometrium and intracavitary pathologies.

Keyword

Sonohysterography; Abnormal uterine bleeding; Endometrial abnormality

MeSH Terms

Ambulatory Care Facilities
Diagnosis
Endometrium
Female
Humans
Hysterectomy
Hysteroscopy
Pathology
Retrospective Studies
Sensitivity and Specificity
Uterine Hemorrhage