EP15.15: Comparison of saline infused sonohysterography with transvaginal ultrasound in endometrial evaluation of premenopausal women

Abstract

To compare diagnostic accuracy of saline infused sonohysterography (SIS) with transvaginal ultrasound (TVS) in detection of endometrial pathology in premenopausal women. We retrospectively analysed a total of 299 premenopausal women (21≤ age <49) who were histologically diagnosed by operative hysteroscopy after TVS and SIS between January 2007 and November 2017 in a single institution. Sensitivity, specificity and likelihood ratio (LR+ and LR-) of TVS and SIS were calculated for the diagnosis of endometrial pathology. In detecting any endometrial pathology, both TVS and SIS had high sensitivity (99.6% vs. 100%), but, specificity of both were low (2.7% vs. 54%). The LR+ of SIS was higher than TVS (2.18 vs. 1.02), and LR- of SIS was lower than TVS (0 vs. 0.14). In detecting endometrial polyp, the sensitivity and specificity of TVS were 90% and 57.5% respectively, with LR+ of 2.1 and LR- of 0.2. The sensitivity and specificity of SIS were 95.9% and 65% with LR+ of 2.7 and LR- of 0.06. The sensitivity and specificity of TVS and SIS in detecting submucosal (SM) uterine leiomyoma were 84.1% and 71%, and 84.1% and 94.5%, respectively. The LR+(15.3) and LR-(0.17) of SIS were higher than those of TVS (LR+ 2.9; LR- 0.2). The area under the curve (AUC) of SIS and TVS in the detection of any endometrial pathology, polyp, and SM uterine leiomyoma were 0.77 and 0.51, 0.8 and 0.74, and 0.89 and 0.78, respectively. The present study proved that SIS is better modality than TVS in detecting any endometrial pathology. In addition, SIS appears to be more effective than TVS in identifying SM uterine leiomyoma. Supporting information can be found in the online version of this abstract Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.