title: Likelihood ratio of sonohysterographic findings for discriminating endometrial polyps from submucosal fibroids.
abstract: OBJECTIVE
  The purpose of this study was to determine which combination of sonohysterographic features has the highest likelihood ratios (LRs) in discriminating polyps from submucosal fibroids.
  
  
  METHODS
  This retrospective study included 200 consecutive patients who underwent both sonohysterography and a procedure resulting in a positive pathologic diagnosis. A reader, masked to the imaging and pathologic findings, independently reviewed the 200 sonograms and recorded the findings using a standardized checklist for sonographic features on sonohysterography. The features assessed included angle, echogenicity, endometrial-myometrial interface, and vascular pattern, among others. The reader chose one final diagnosis from the list of possibilities, which included normal, hyperplasia, polyp, submucosal fibroid, cancer, adhesions, and clots. Sonographic observations were then compared to pathologic findings.
  
  
  RESULTS
  The LR of 13.4 was achieved for polyps when there was a combination of an intact endometrial-myometrial interface, a single vessel, an acute angle, and homogeneous echogenicity. The highest LR of 27.8 was achieved for submucosal fibroids when the combination of sonographic features included an absent endometrial-myometrial interface, an arborized/multiple vascular pattern, an obtuse angle, and heterogeneous echogenicity.
  
  
  CONCLUSIONS
  A combination of sonographic findings may provide high LRs for discriminating endometrial polyps from submucosal fibroids.
authors.affiliation: MBDNB, DABR, Department of Medical Imaging Schulich School of Medicine and Dentistry, University of Western Ontario, London Health Sciences Center-Victoria Hospital, 800 Commissioners Rd E, Room D1-106, London, ON N6A 5W9, Canada. mousumi.bhaduri@lhsc.on.ca.
authors.forename: Mousumi
authors.initials: M
authors.lastname: Bhaduri
authors.forename: George
authors.initials: G
authors.lastname: Tomlinson
authors.forename: Phyllis
authors.initials: P
authors.lastname: Glanc
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007889:Leiomyoma / Q000175:diagnosis*; D016013:Likelihood Functions; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
keywords: fibroids; gynecologic ultrasound; likelihood ratio; polyps; sonohysterographic features