3275: The diagnostic accuracy of transvaginal sonography in uterine pathology

Abstract

Objectives: The purpose of this study is to evaluate the diagnostic accuracy in uterine pathology between transvaginal ultrasound and hysteroscopy. Methods: During the period from January 1995 to May 2005, 277 women underwent hysteroscopy combined with transvaginal ultrasound due to evaluate the cause of infertility and endometrial pathology at Department of Obstetrics and Gynecology in Korea University Hospital. Results: Mean age of the study group was 37.3 and mean parity was 1.13. According to pathologic reports, final diagnosis were normal finding (43.5%), polyp (20.8%), submucosal myoma (11.1%), endometritis (9.7%), endometrial hyperplasia (2.8%) and endometrial cancer (1.4%) etc. The transvaginal ultrasound showed 57.89% sensitivity, 65.26% specificity and 75.0% positive predictive value in detecting endometrial lesions. The sensitivity, specificity and positive predictive value of hysteroscopy were 92.61%, 69.66% and 85.5%, respectively. Overall agreement of transvaginal ultrasound and hysteroscopic finding was 58.7%. Hysteroscopy showed much higher detection rate in case of synechiae and endometritis compared with transvaginal ultrasound. Conclusions: Hysteroscopy was significantly better diagnostic procedure than transvaginal ultrasound. But transvaginal ultrasound also helpful in diagnosis of polyp, submucosal myoma and in evaluation of myometrium and adnexa. So, we concluded that both hysteroscopy and transvaginal ultrasound are useful methods in detection of endometrial lesion.