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Korean Journal of Obstetrics & Gynecology 2006;49(3):653-659.
Published online March 1, 2006.
Clinical Usefulness of Transvaginal sonography and sonohysterography in evaluation of endometrial abnormalities.
Jae Shik Hong, Myung Seop Song, Jae Youn Lim, Hyun Jung Lee, Ka Young Ahn, Jun Shik Hong, Joo Myung Kim, Jae Bum Yeon, Kwan Young Joo, Kue Hong Choi
1Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, Sungkyunkwan University School of Medicine, Korea. dr66205@freechal.com
2Department of Obstetrics and Gynecology, Sanborn Jeil Women's Hospital, Korea.
Abstract
OBJECTIVE
The aim of our study is to evaluate the clinical usefulness of transvaginal sonography (TVS) and saline infusion sonohysterography (SHG) in the evaluation of endometrial abnormality. METHODS: We retrospectively reviewed 370 patients with abnormal uterine bleeding or uterine cavity abnormalities confirmed by TVS. SHG was carried out by experienced gynecologist, on the same setting in an outpatient clinic after the performance of TVS. Two hundred nineteen patients aged between 23 and 69 years (mean age 41+/-8.2) had operative hysteroscopy (88.2%), hysterectomy (9.1%) and dilatation/curettage (2.7%) within 3 months which provided a detailed description of uterine cavity. Surgical-pathologic findings were compared with the results obtained from TVS and SHG. RESULTS: The sensitivity and specificity were 71.7% and 31.4% for TVS, and 98.4% and 67.6% for SHG respectively. The positive and negative predictive values were 84.6% and 17.5% for TVS, and 94.3% and 92.3% for SHG, respectively. Twenty one cases showed a discrepancy between the TVS and SHG, and 16 cases showed a discrepancy between SHG and the pathologic diagnosis. Fifty five cases (25%) in TVS were unconfirmed, but SHG showed 51 pathologic confirmed intracavitary lesion. CONCLUSION: SHG is a sensitive tool and is superior to TVS used alone for evaluation of endometrial abnormalities. SHG definitely enhances the diagnostic potential of TVS in assessment of endometrium and intracavitary pathologies.
Key Words: Sonohysterography, Abnormal uterine bleeding, Endometrial abnormality


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