title: 3D sonohysterography vs hysteroscopy: a cross-sectional study for the evaluation of endouterine diseases.
abstract: OBJECTIVE
  To assess the concordance between the presumed diagnosis obtained with the 3D sonohysterography (SHG) and with the diagnostic hysteroscopy (HYS); to determine whether the 3D SHG has the accuracy needed to be considered as a diagnostic screening standard in cases of suspected endouterine pathology.
  
  
  METHODS
  We selected 224 patients who voluntarily decided to undergo 3D SHG from a population with suspected presence of endouterine disease at TVS. The patients underwent first 3D SHG and then diagnostic HYS. We recorded each patient's discomfort/pain during the two techniques. We used the "Bayes Theorem" to calculate the sensitivity and specificity of the 3D SHG as compared to HYS.
  
  
  RESULTS
  Overall the 3D SHG diagnosis was confirmed in 156/224 cases (69.64 %). Concordance for endometrial thickening was 0 %; for Asherman's syndrome was 50.00 %; for polyp was 77.78 %; and for myoma, mucus accumulation and Müllerian anomalies (arcuate uterus, septate and subseptate uterus) was 100.00 %. Furthermore, 3D SHG was better tolerated than HYS.
  
  
  CONCLUSIONS
  Despite the diagnostic accuracy and mini-invasiveness of 3D SHG, we suggest that it cannot be a substitute of HYS in endouterine disease diagnosis, but it could be considered as a good method of screening to address patients to hysteroscopic confirmation.
authors.affiliation: Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences, University of Messina, Via C. Valeria 1, 98125, Messina, Italy, antlagana@unime.it.
authors.forename: Antonio Simone
authors.initials: AS
authors.lastname: Laganà
authors.forename: Leonarda
authors.initials: L
authors.lastname: Ciancimino
authors.forename: Alfredo
authors.initials: A
authors.lastname: Mancuso
authors.forename: Benito
authors.initials: B
authors.lastname: Chiofalo
authors.forename: Pietro
authors.initials: P
authors.lastname: Rizzo
authors.forename: Onofrio
authors.initials: O
authors.lastname: Triolo
mesh_terms: D000328:Adult; D001499:Bayes Theorem; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D011247:Pregnancy; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014591:Uterine Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging