title: Diagnostic accuracy of sonohysterography and transvaginal sonography as compared with hysteroscopy and endometrial biopsy: a prospective study.
abstract: OBJECTIVE
  The aim of the study was to compare the diagnostic accuracy between transvaginal sonography (TVS) and sonohysterography (SHG) versus hysteroscopy (Hys) plus endometrial biopsy (EB) to evaluate uterine cavity.
  
  
  METHODS
  One hundred and sixteen patients were enrolled. These presented with infertility and/or abnormal uterine bleeding and/or suspicious uterine cavity pathology. Women consecutively underwent during the same day, to TVS, SHG and Hys plus EB by three different operators.
  
  
  RESULTS
  TVS shows excellent specificity (95.7%) in uterine polyps detection, good sensitivity (85,7%) and specificity (89.2%) in investigating endometrial hyperplasia, and excellent NPV (92.2%) in the diagnosis of submucous myomas. Diagnostic accuracy of TVS for synechiae is not evaluable. SHG demonstrates high specificity (92.8%) in the detection of uterine polyps, and high sensitivity (92.9%) and specificity (96.8%) in the diagnosis of endometrial hyperplasia. In addition it shows high sensitivity (90%), specificity (99%), PPV (92.2%), and NPV (99%) for detection of submucous myomas. Finally, SHG shows high PPV (100%) and NPV (100%) for synechiae assessment.
  
  
  CONCLUSIONS
  TVS could be used as first step investigation to exclude uterine pathologies. TVS could reduce the number of diagnostic Hys normally performed in women with normal uterine cavity. Furthermore SHG should be useful to diagnose the pathologies and to decide between operative Hys in-office or resectoscopic treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy.
authors.forename: G B
authors.initials: GB
authors.lastname: La Sala
authors.forename: I
authors.initials: I
authors.lastname: Blasi
authors.forename: A
authors.initials: A
authors.lastname: Gallinelli
authors.forename: C
authors.initials: C
authors.lastname: Debbi
authors.forename: G
authors.initials: G
authors.lastname: Lopopolo
authors.forename: V
authors.initials: V
authors.lastname: Vinci
authors.forename: M T
authors.initials: MT
authors.lastname: Villani
authors.forename: F
authors.initials: F
authors.lastname: Iannotti
mesh_terms: D000328:Adult; D000465:Algorithms; D001706:Biopsy; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D007247:Infertility, Female / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008796:Metrorrhagia / Q000000981:diagnostic imaging; D008875:Middle Aged; D009214:Myoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011127:Polyps / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery