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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.

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A 58 year-old postmenopausal woman presented with vaginal spotting.A. Longitudinal image of transvaginal ultrasonography shows a small hyperechoic nodule (arrows) in the endometrium. It was regarded as a small polyp.B. Longitudinal image of hysterosonography shows a thin endometrium without any focal lesion. On the 1 month follow-up transvaginal ultrasonography, the small nodule disappeared and the vaginal spotting disappeared as well.
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Figure 6: A 58 year-old postmenopausal woman presented with vaginal spotting.A. Longitudinal image of transvaginal ultrasonography shows a small hyperechoic nodule (arrows) in the endometrium. It was regarded as a small polyp.B. Longitudinal image of hysterosonography shows a thin endometrium without any focal lesion. On the 1 month follow-up transvaginal ultrasonography, the small nodule disappeared and the vaginal spotting disappeared as well.

Mentions: The sensitivity and specificity of TVS were 79.0% and 45.8%, respectively (Table 2). The false negative cases included six hyperplasia, four small polyps of less than 5 mm in size, three submucosal leiomyomas, two adenomyomas (falsely considered as intramural lesions), a case of synechia and a case of chronic endometritis. The six false-positive lesions demonstrated focal thickening of the endometrium (Fig. 6), which include a case of diffuse thickening, four cases of endometrial polyps and a case with suspected submucosal leiomyomas.


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 58 year-old postmenopausal woman presented with vaginal spotting.A. Longitudinal image of transvaginal ultrasonography shows a small hyperechoic nodule (arrows) in the endometrium. It was regarded as a small polyp.B. Longitudinal image of hysterosonography shows a thin endometrium without any focal lesion. On the 1 month follow-up transvaginal ultrasonography, the small nodule disappeared and the vaginal spotting disappeared as well.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: A 58 year-old postmenopausal woman presented with vaginal spotting.A. Longitudinal image of transvaginal ultrasonography shows a small hyperechoic nodule (arrows) in the endometrium. It was regarded as a small polyp.B. Longitudinal image of hysterosonography shows a thin endometrium without any focal lesion. On the 1 month follow-up transvaginal ultrasonography, the small nodule disappeared and the vaginal spotting disappeared as well.
Mentions: The sensitivity and specificity of TVS were 79.0% and 45.8%, respectively (Table 2). The false negative cases included six hyperplasia, four small polyps of less than 5 mm in size, three submucosal leiomyomas, two adenomyomas (falsely considered as intramural lesions), a case of synechia and a case of chronic endometritis. The six false-positive lesions demonstrated focal thickening of the endometrium (Fig. 6), which include a case of diffuse thickening, four cases of endometrial polyps and a case with suspected submucosal leiomyomas.

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