Limits...
Comparison of transvaginal ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding.

Ryu JA, Kim B, Lee J, Kim S, Lee SH - Korean J Radiol (2004 Jan-Mar)

Bottom Line: All 105 patients were initially evaluated on the same day with both TVS and HS.The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively.Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding.

Materials and methods: We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings.

Results: The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis.

Conclusion: TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.

Show MeSH

Related in: MedlinePlus

A 48 year-old premenopausal woman presented with menorrhagia and dysfunctional uterine bleeding.A. Longitudinal image of transvaginal ultrasonography shows a homogeneously hyperechoic 12-mm-thick endometrium without any focal lesion, which looks normal.B. Longitudinal image of hysterosonography shows an elongated endometrial mass (arrows), which was regarded as endometrial hyperplasia. Curettage biopsy was done and an endometrial polyp was confirmed upon pathologic examination.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2698112&req=5

Figure 3: A 48 year-old premenopausal woman presented with menorrhagia and dysfunctional uterine bleeding.A. Longitudinal image of transvaginal ultrasonography shows a homogeneously hyperechoic 12-mm-thick endometrium without any focal lesion, which looks normal.B. Longitudinal image of hysterosonography shows an elongated endometrial mass (arrows), which was regarded as endometrial hyperplasia. Curettage biopsy was done and an endometrial polyp was confirmed upon pathologic examination.

Mentions: Pathologic examination revealed the presence of 37 endometrial polyps (35%) (Figs. 2, 3), 26 submucosal leiomyomas (25%) (Fig. 4), 12 endometrial hyperplasia (11%), three endometrial carcinomas (3%) and two adenomyomas (2%) (Fig. 5). One patient had uterine synechia, and twenty-four of 105 patients (23%) showed no organic cause for uterine bleeding (Table 1).


Comparison of transvaginal ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding.

Ryu JA, Kim B, Lee J, Kim S, Lee SH - Korean J Radiol (2004 Jan-Mar)

A 48 year-old premenopausal woman presented with menorrhagia and dysfunctional uterine bleeding.A. Longitudinal image of transvaginal ultrasonography shows a homogeneously hyperechoic 12-mm-thick endometrium without any focal lesion, which looks normal.B. Longitudinal image of hysterosonography shows an elongated endometrial mass (arrows), which was regarded as endometrial hyperplasia. Curettage biopsy was done and an endometrial polyp was confirmed upon pathologic examination.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698112&req=5

Figure 3: A 48 year-old premenopausal woman presented with menorrhagia and dysfunctional uterine bleeding.A. Longitudinal image of transvaginal ultrasonography shows a homogeneously hyperechoic 12-mm-thick endometrium without any focal lesion, which looks normal.B. Longitudinal image of hysterosonography shows an elongated endometrial mass (arrows), which was regarded as endometrial hyperplasia. Curettage biopsy was done and an endometrial polyp was confirmed upon pathologic examination.
Mentions: Pathologic examination revealed the presence of 37 endometrial polyps (35%) (Figs. 2, 3), 26 submucosal leiomyomas (25%) (Fig. 4), 12 endometrial hyperplasia (11%), three endometrial carcinomas (3%) and two adenomyomas (2%) (Fig. 5). One patient had uterine synechia, and twenty-four of 105 patients (23%) showed no organic cause for uterine bleeding (Table 1).

Bottom Line: All 105 patients were initially evaluated on the same day with both TVS and HS.The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively.Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding.

Materials and methods: We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings.

Results: The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis.

Conclusion: TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.

Show MeSH
Related in: MedlinePlus