title: [Sensitivity and specificity of hysterosonography in endometrial abnormalities in asymptomatic postmenopausal women].
abstract: BACKGROUND
  To estimate sensitivity and specificity of hysterosonography for diagnosis of endometrial cavity abnormalities. The gold-standard was hysteroscopy; to compare the agreement between ultrasonographic, hysterosonographic and hysteroscopic findings using the KIA (Kappa Index Agreement).
  
  
  METHODS
  Fifty asymptomatic postmenopausal women that had a suspicion of endometrial abnormalities based upon transvaginal ultrasonography were studied. Hysterosonography, diagnostic hysteroscopy and oriented biopsy were performed and the Kia was used to compare results.
  
  
  RESULTS
  The most frequent abnormalities were polyps (58%), synechiae (20%), submucous myoma (12%) and endometrial thickening (6%). The uterine cavity was considered normal in 4% of the evaluations by hysteroscopy. The sensitivity of hysterosonography to diagnose polyps was of 89.7%, the specificity of 81.0% and the KIA of 71.1%. For synechia sensitivity of hysterosonography was of 80%, specificity of 100% and the KIA of 86.5%; for submucous myoma sensitivity was of 83.3%; specificity of 97.7% and the KIA of 81.1%, and for endometrial thickening, sensitivity was of 33.3%, specificity of 89.4% and the KIA of 15.5%.
  
  
  CONCLUSIONS
  Hysterosonography showed very good agreement with hysteroscopy for the diagnosis of synechiae and submucous myomas; good agreement for polyps and poor agreement for endometrial thickening. Based upon this data hysterosonography may be deemed a simple, efficient, and accurate method for the evaluation of the uterine cavity in the postmenopausal period.
authors.affiliation: Departamento de Obstetricia e Ginecologia, Irmandade da Santa Casa de Misericórdia, São Paulo. sonia.tamanaha@ig.com.br
authors.forename: Sonia
authors.initials: S
authors.lastname: Tamanaha
authors.forename: José Mendes
authors.initials: JM
authors.lastname: Aldrighi
authors.forename: Roberto Euzébio dos
authors.initials: RE
authors.lastname: Santos
authors.forename: Roberto Adelino Almeida
authors.initials: RA
authors.lastname: Prado
mesh_terms: D004717:Endometrium / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods* / Q000592:standards; D009214:Myoma / Q000000981:diagnostic imaging; D011127:Polyps / Q000000981:diagnostic imaging; D017698:Postmenopause / Q000502:physiology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods / Q000592:standards