Transvaginal Ultrasonography and Saline Infusion
Sonography Compared to Hysteroscopy for Diagnosis
of Intracavity Lesion: A 4-Year Experience in Suburban
Referral Hospital
Phaliwong P, MD¹, Luangdansakul W, MD², Bhamarapravatana K, PhD³, Suwannarurk K, MD⁴
Affiliation : ¹ Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Bangkok, Thailand ² Fetomaternal Medicine Unit, Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Bangkok, Thailand ³ Department of Preclinical Science, Faculty of Medicine, Thammasat University Hospital, Bangkok, Thailand ⁴ Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University Hospital, Bangkok, Thailand
Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the
diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold
standard for final diagnosis.
Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined.
Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively.
Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS.
Received 31 May 2019 | Revised 20 Aug 2019 | Accepted 21 Aug 2019
doi.org/10.35755/jmedassocthai.2020.06.10240
Keywords : Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy
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