A prospective comparison of transvaginal ultrasound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology.
OBJECTIVE
To compare the diagnostic performance of saline infusion sonohysterography (SIS), transvaginal ultrasound (TVS), and diagnostic hysteroscopy (DH) in the detection of endometrial lesions in symptomatic women.


METHODS
Prospective, comparative study.


METHODS
Obstetrics and Gynecology Department of a tertiary academic hospital.


METHODS
A total of 105 consecutive women presenting in an outpatient clinic with symptoms of menorrhagia, postmenopausal bleeding, and infertility.


METHODS
Each patient had TVS, SIS, and DH.


METHODS
The sensitivity, specificity, and positive and negative likelihood ratios (LR+ and LR-) for TVS, SIS, and DH were determined for the diagnosis of endometrial pathology. More specifically, the diagnostic performance of each of these three methods was compared after receiver operating characteristic analysis.


RESULTS
By comparative analysis of the area under the curve, DH was found to have a significantly better diagnostic performance compared to SIS and TVS. In addition, after comparing the receiver operating characteristic curves, DH was found to be significantly more precise in the diagnosis of intracavitary masses than TVS and SIS. However, SIS was more accurate compared to TVS.


CONCLUSIONS
Saline infusion sonohysterography appears to be more valuable than TVS in the diagnosis of intracavitary masses (both polyps and myomas).
Grimbizis
Grigoris F
GF
First Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece. grimbi@med.auth.gr
Tsolakidis
Dimitrios
D
Mikos
Themistoklis
T
Anagnostou
Eftychia
E
Asimakopoulos
Efstratios
E
Stamatopoulos
Panagiotis
P
Tarlatzis
Basil C
BC
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000009:adverse effects / Q000379:methods; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D012965:Sodium Chloride / Q000008:administration & dosage*; D014463:Ultrasonography; D014591:Uterine Diseases / Q000000981:diagnostic imaging*; D014599:Uterus / Q000000981:diagnostic imaging*; D014621:Vagina / Q000000981:diagnostic imaging*
D012965:Sodium Chloride