3D/4D Ultrasound Transvaginal Ultrasound Can Be A Useful Alternative to Saline Infusion Sonohysterography for Evaluation of Polyps

Abstract

Several techniques are available for diagnosing the cause of abnormal uterine bleeding including transvaginal ultrasound (TVUS), saline infusion sonohysterography (SIS), and hysteroscopy. Hysteroscopy is the gold standard to diagnosis of endometrial polyps, however, is an invasive procedure. Minimally invasive SIS has been compared to TVUS and found to be superior for the diagnosis of endometrial polyps. The purpose of this study was to evaluate the accuracy of 3D/4D transvaginal ultrasound (3D/4D TVUS) and SIS for the evaluation of endometrial polyps for women with abnormal uterine bleeding or postmenopausal bleeding. Between 2009 and 2011, 159 women with abnormal uterine bleeding or postmenopausal bleeding were evaluated with 3D/4D TVUS, SIS, and hysteroscopy. Pathology was obtained from either a dilation and curettage or hysterectomy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for TVUS and SIS for diagnosing endometrial polyps were determined. After endometrial polyps were confirmed with histology, the sensitivity and specificity of 3D/4D TVUS for the diagnosis of polyps were 91.3% and 90.9% respectively. The sensitivity and specificity of SIS were 97.3% and 96% respectively. The PPV and NPV for 3D/4D TVUS were 96% and 80%, while the PPV and NPV for SIS were 96.5% and 93%. In this study, we compared the accuracy of TVUS to SIS to diagnose endometrial polyps. Previous studies have analyzed the ability non 3D/4D TVUS to correctly diagnose endometrial polyps. With the advancement 3D/4D technology to ultrasound, the ability to accurately diagnose polyps may eliminate the need for further testing with SIS if the diagnosis is endometrial polyps.