Comparison of transvaginal ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding.
OBJECTIVE
To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding.


METHODS
We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings.


RESULTS
The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis.


CONCLUSIONS
TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.
Ryu
Jeong-Ah
JA
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim
Bohyun
B
Lee
Jongmee
J
Kim
Sooah
S
Lee
Sang Hoon
SH
D000328:Adult; D000368:Aged; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology