title: A prospective comparison of transvaginal ultrasound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology.
abstract: 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).
authors.affiliation: First Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece. grimbi@med.auth.gr
authors.forename: Grigoris F
authors.initials: GF
authors.lastname: Grimbizis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsolakidis
authors.forename: Themistoklis
authors.initials: T
authors.lastname: Mikos
authors.forename: Eftychia
authors.initials: E
authors.lastname: Anagnostou
authors.forename: Efstratios
authors.initials: E
authors.lastname: Asimakopoulos
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Stamatopoulos
authors.forename: Basil C
authors.initials: BC
authors.lastname: Tarlatzis
mesh_terms: 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*
chemical_list: D012965:Sodium Chloride