Accuracy Of Transvaginal Sonography Research Articles

Transvaginal Ultrasound vs. Magnetic Resonance Imaging: What Is the Optimal Imaging Modality for the Diagnosis of Endometriosis?

Endometriosis, an intriguing gynecological illness, poses a substantial health concern for women of reproductive age, despite its widespread occurrence and limited comprehension. The objective of this study is to assess the diagnostic precision of transvaginal sonography (TVS) and pelvic magnetic resonance imaging (MRI) for the identification of deep infiltrated endometriosis (DIE). This study encompassed a cohort of 256 patients exhibiting signs and symptoms of endometriosis, with the aim of assessing the diagnostic accuracy over a span of four years. Both TVS and pelvic MRI were employed in the same centers to analyze each subject. The histopathologic analysis and laparoscopy were the most reliable and widely accepted methods for evaluation. TVS is a reliable diagnostic tool for ovarian endometriomas, obviating the necessity for MRI confirmation. The specificity of TVS in diagnosing ovarian endometriomas is 57.14%, while its sensitivity is 93.78%, resulting in an overall accuracy of 84.47%. In relation to parametrial lesions, the sensitivity, specificity, and accuracy of TVS and MRI were as follows: TVS: 9%, 97%, 32%, MRI: 27.14%, 89.19%, and 40.11%. Concerning the uterosacral lesions, the sensitivity, specificity, and accuracy of TVS and MRI were as follows: TVS:14.63%, 94.74%, and 55%, while MRI: 65.88%, 66.30%, and 66.1%. Regarding rectal endometriosis, the sensitivity, specificity, and accuracy of TVS and MRI were as follows: 69.72%, 76.87%, and 73.82% for TVS, and 66.28%, 94.51%, and 80.79% for MRI. The results of the present study indicate that whereas MRI generally exhibits superior capability in assessing the severity of endometriosis, TVS demonstrates sufficient diagnostic accuracy in DIE comparable to MRI.

Diagnostic Accuracy of Trans Vaginal Sonography in Detecting Vesicovaginal Fistula

Objective: The aim to conduct this study was to establish the diagnostic accuracy of trans vaginal sonography to detect vesicovaginal fistula. Findings are compared with cystogram and surgical results, taking later as gold standard. Settings: The study was conducted in the Department of Radiology, FJMU/Sir Ganga Ram Hospital, Lahore Pakistan. Duration: September 2022 to March 2023. Methods: All patients who were included in study, were married females within age bracket of 32-42 years, who presented in outpatient department with the complaint of urinary incontinence. Trans vaginal ultrasound was performed after verbal consent. Findings were compared with cystogram and surgical results, taking later as gold standard. Patients who suffered stress incontinence during physical movement or activity were excluded from this study. Results: A total of 25 patients were taken. The age range was 32-42years with mean age of 36years. The fistulae were seen by transvaginal ultrasound in all cases with the site, size and number of communicating tracts corresponding with operative results. Trans vaginal sonography reveals 100% sensitivity to detect vesicovaginal fistulae. Conclusion: We recommend transvaginal ultrasound as an accurate imaging modality for detecting vesicovaginal fistula because its findings are correlated well with the surgical results and is non-invasive, safe, non-hazardous and without any risk of radiation exposure.

Echosonography’s accuracy of intrauterine pathology’s diagnostics in reproductive-age women

Introduction. Accuracy of transvaginal sonography (TVS) is substantial as the first-line approach of intrauterine pathology diagnostics. However, TVS has some limitations and factors that reduce its accuracy have not been definitively determined.Aim. To evaluate the diagnostic accuracy of echography in intrauterine pathology and identify factors affecting it. Materials and methods. The study included 250 women who underwent hysteroscopy with endometrial biopsy: 128 with endometrial polyps (EP), 33 with endometrial hyperplasia (EH), 28 with chronic endometritis (CE) and 60 women without endometrial pathology.Results. The sensitivity and specificity of ultrasound in diagnosis of EP was 64.8% and 77.9%, respectively, EH – 64.7% and 89.8%, CE – 39.3% and 90.1%. Cumulative intrauterine pathology’s sensitivity reached 94.7%, and the specificity – 15.0%, which indicates a significant amount of false positive results. The lowest accuracy was in CE, EP less than 0.6 cm and in the absence of abnormal uterine bleeding.Conclusions. TVS has limitations in verifying a specific diagnosis and characterized by both hyper- and hypodiagnosis. The clinician should take into account the size of the EP and the presence of symptoms for choosing optimal management.

Correlation between preoperative imaging biomarkers and histological prognostic factors in endometrial cancer: A prospective study.

We compared transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) for detecting myometrial infiltration, cervical involvement, and for measuring tumor volume in endometrial cancer patients. We also correlated tumor volume to worse histological prognostic factors. We recruited women with a histological diagnosis of endometrial cancer between March 2019 and March 2021. Inclusion criteria were: age ≥ 18 years, written informed consent, biopsy-proven endometrial cancer, absence of previous neoadjuvant chemo- or radiotherapy treatment, patient suitable for primary surgery. Exclusion criteria were: advanced disease stage and other coexisting malignant tumors. TVUS and MRI were used, in the absence of any contraindication. We compared the preoperative imaging results with final histopathology. The accuracy of TVUS and MRI in evaluating myometrial infiltration, cervical invasion and tumor volume were comparable. A tumor volume ≥2 ml showed a positive correlation with worse histological prognostic factors, such as high tumor grade, diffuse lymphvascular space involvement (LVSI) and deep myometrial invasion (p < 0.05). TVUS should be used as first-line imaging modality, being more available, cost-effective, and more acceptable by patients. A careful local staging of endometrial cancer patients before surgery is fundamental in order to improve tailored treatment and minimize costs.

Accuracy of transvaginal ultrasound and magnetic resonance imaging for diagnosis of deep endometriosis in bladder and ureter: a meta-analysis

This meta-analysis aimed to determine the accuracy of transvaginal ultrasound (TVS) and pelvic magnetic resonance imaging (MRI) in diagnosing urinary tract endometriosis (UTE). A comprehensive search of the Pubmed and Embase was conducted between January 1989 and June 2020. Studies that described the accuracy of MRI or TVS for the diagnosis of UTE using surgical data as the reference standard were included. Of the 913 citations identified, 23 studies were analysed. For detection of endometriosis in bladder endometriosis (BE), the overall pooled sensitivities of TVS and MRI were 72% and 68% respectively, and their specificities were 99% and 100% respectively. For detection of endometriosis in the ureteral endometriosis (UE), the overall pooled sensitivities of TVS and MRI were 97% and 87% respectively, and their specificities were both 100%. In conclusion, both TVS and MRI provide good accuracy with specific strong points in diagnosing UTE and seem useful first-line methods from a clinical perspective. Besides, pelvic MRI and TVS are more accurate for predicting UTE localised in the ureter than bladder, especially in terms of sensitivity. IMPACT STATEMENT What is already known on this subject? Previous studies have confirmed high diagnostic value of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) on bladder endometriosis (BE) respectively. However, high heterogeneity was found for both sensitivity and specificity and no meta-analysis has yet been performed to test the diagnostic value of TVS and MRI for ureteral endometriosis (UE). What the results of this study add? In this meta-analysis, we firstly confirmed high diagnostic value of TVS and MRI on UE respectively. For detection of UE, the overall pooled sensitivities of TVS and MRI were 97% and 87% respectively, and their specificities were both 100%. What the implications are of these findings for clinical practice and/or further research? Early preoperative diagnosis and accurate understanding of the widespread distribution of endometriosis are prerequisites for radical surgical in UTE. In the present study, we updated the previous results on the accuracy of TVS and MRI for the diagnosis of BE and firstly confirmed high diagnostic value of TVS and MRI on UE. Both TVS and MRI provide good accuracy with specific strong points in diagnosing UTE and seem useful first-line methods from a clinical perspective.

Diagnostic Accuracy of Transvaginal Versus Transabdominal Ultrasonography for Diagnosing Adnexal Masses

Objective: Purpose of our study is to diagnose accuracy of transvaginal versus transabdominal ultrasonography for diagnosing adnexal masses. Study Design: Cross-sectional/Comparative study Place and Duration: Sadiq Abassi Hospital Bahawalpur. March 2021 - Oct 21 Methods: There were one hundred and twenty females were presented in this study. Females were aged between 18-55 years. As part of the informed written consent process, all of the patients were asked to provide demographic information including their age, gender, monthly abnormalities (Oligomenorrhea / Amenorrhea), infertility, recurrent pregnancy loss, hirsuitism, and acne vulgaris and obesity. The location, size, borders, echogenicity, soft tissue component, septations, and nodularity of ovarian lesions were evaluated on a grey scale. Patients were equally divided into two groups, group I had 60 cases and received transvaginal ultrasonography while group II received transabdominal ultrasonography with MRI. Outcomes among both groups were compared in terms of frequency of adnexal mass by using histopathological findings (positive/negative). SPSS 25.0 version was used to analyze complete data. Results: There was no any significantly difference between age and body mass index among both groups. Mean parity in group I was 2.34±4.14 and I group II was 1.14±7.38. Infertility and irregular cycle was the most common complaints among both groups in 28 (46.7%), 26 (43.3%) and 21 (35%), 24 (40%). Frequency of adnexal mass in transvaginal ultrasonography was found among 32 (53.3%) but in group II (transabdominal ultrasonography) adnexal mass found in 36 (60%) cases. According to histopathological among 32 cases of transvaginal sonography 26 had true positive and 6 had false negative and in group II 32 cases had true and 4 cases had false positive results. We found that accuracy of transvaginal sonography was lower than that of transabdominal sonography in terms of specificity, positive predictive value and negative predictive value. Conclusion: We concluded in this study that abdominal ultrasonography with MRI was more beneficial and effective in terms of diagnosing adnexal masses with authentic values of specificity and sensitivity. Keywords: Adnexal Masses, Transabdominal ultrasonography, Transvaginal ultrasonography, Complications, Accuracy

Transvaginal ultrasonography versus hysteroscopy in endometrial pathology diagnosis among women with abnormal uterine bleeding

Objective: Abnormal uterine bleeding is any deviation from a normal menstrual pattern. Transvaginal ultrasonography is useful in determining endometrial thickness but cannot conclusively exclude sessile and pedunculated lesions. Hysteroscopy is an invasive procedure that detects discrete lesions. This study was aimed to evaluate the diagnostic accuracy of 2-dimensional transvaginal ultrasonography and hysteroscopy in evaluating endometrial lesions in women with abnormal uterine bleeding, by determining the sensitivity and specificity of the two methods in diagnosing the lesions. Methods: Eighty-four cases of abnormal uterine bleeding were chosen based on inclusion criteria. The patients were subjected to routine investigations. The findings of transvaginal ultrasonography, hysteroscopy, and dilatation and curettage were compared and analyzed. Results: Maximum incidence of abnormal uterine bleeding was observed in women between 41 and 50 years of age (73.8%). The most common presenting complaint was menorrhagia (76.1%). 76% of patients experienced symptoms for less than six months. The sensitivity and specificity of transvaginal ultrasonography were 60% and 96.3%, respectively. The sensitivity and specificity of hysteroscopy were 80.4% and 93.1%, respectively. The accuracy of transvaginal ultrasonography was 60.3%, and that of hysteroscopy was 83.3%. Conclusion: Transvaginal ultrasonography and hysteroscopy can be used as first-line diagnostic modalities to rule out and find the causes of abnormal uterine bleeding, which can aid in instituting prompt and appropriate medical treatment.

Role of Transvaginal Ultrasonography in Diagnosing Endometrial Hyperplasia in Postmenopausal Women with Abnormal Uterine bleeding taking Histopathology as Gold Standard

Aim: Diagnostic accuracy of transvaginal ultrasonography in diagnosing endometrial hyperplasia in post-menopausal women with abnormal uterine bleeding taking histopathology as gold standard. Settings &amp; duration: Department of Radiology, CMH, Rawalpindi from 25-08-17 to 24-02-18 Methodology: A total of 203 post-menopausal females having AUB were included. Patients who had cervical and vaginal pathologies other than EH were excluded. The ultrasound was done with Endovaginal probe of Toshiba aplio 500. On ultrasound, endometrial thickness was taken. Endometrial biopsy was carried out using hysteroscopy. Final diagnosis was based upon histopathology report. Results: In TVS positive patients, 103 were True Positive and 12 were False Positive. Among 88 TVS negative patients, 04 were False Negative whereas 84 were True Negative (p=0.01). Overall sensitivity, specificity, PPV, NPV and diagnostic accuracy of transvaginal ultrasonography in diagnosing endometrial hyperplasia in post-menopause women with abnormal uterine bleeding taking histopathology as gold standard was 96.3%, 87.5%, 89.6%, 95.5% and 92.1% respectively. Conclusion: Diagnostic accuracy of TVS in diagnosing endometrial hyperplasia in post-menopause women with AUB is high, so TVS should be the first line investigation in diagnosis of endometrial hyperplasia. Keywords: Abnormal uterine bleeding, TVS, endometrial hyperplasia

The place of transvagınal ultrasonography saline infusion sonohysterography and hysteroscopy in the diagnosis of abnormal uterine bleedings

Aim: To establish the accuracy oftransvaginal ultrasonography, saline infusion sonohysterography and hysteroscopy in diagnosing uterine pathology in patients with abnormal uterine bleeding. &#x0D; Material Metod : In our study, Transvaginalultrasonography (TVUSG), Saline infusion sonohystygraphy (SIS) and Hysteroscopy were applied to 60 patients in the reproductive period, who did not use any contraception method other than condom, who did not have chronic and systemic diseases, who applied to our clinic with abnormal uterine bleeding. Dilatation &amp; Curettage (D&amp;C) was applied to all patients after the procedure. Histopathology results obtained with D&amp;C were compared with those obtained with TVUSG, SIS and Hysteroscopy.&#x0D; Results: Histopathologically,28 patients (46.7%) endometrial polyp, 4 patients (6.7%) submucomyomia, 10 patients (16.7%) endometrial hyperplasia was in the form of endometrial changes due to cycle irregularities in 18 patients (30%). The sensitivity, specifieity, positive and negative predictive values for detection of intracavitary pathology by transvaginal sonography were 71,42%, 77,78%, 88,23%, 83,85%. The value s determined by saline infusion sonohysterography were respeetively 88.89%, 90,48%, 80.00%, 95.0% and the values determined by hysteroseopy were respeetively 100%,90.00%,95,24%, 100%. &#x0D; Conclusion: TVUSG and SIS is a cheaper, easier and highly diagnostic value procedure for detecting endometrial pathologies such as endometrial polyps and submucous myomas. However, due to the high diagnostic values, low complication rates, direct biopsy and simultaneous treatment, we believe that hysteroscopy will maintain its 'gold standard' feature in the diagnosis and treatment of endometrial pathologies for many years.

Accuracy of Transvaginal Ultrasonography for Diagnosis of Endometriosis Taking Laparoscopy as Gold Standard

&lt;p&gt;&lt;strong&gt;Background and Objective:&lt;/strong&gt; Endometriosis is a common gynaecological disease with a diverse clinical presentation. Laparoscopy has long been considered the gold standard diagnostic modality for endometriosis but with the evolution of non-invasive, high resolution transvaginal ultrasonography, it is frequently used as the first line diagnostic technique in making a preoperative diagnosis for endometriosis. This study was designed to determine the diagnostic accuracy of transvaginal ultrasonography (TVS) in diagnosis of endometriosis taking laparoscopy as gold standard.&lt;br /&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 118 women of child bearing age who presented with symptoms of pelvic endometriosis in the department of gynecology, Bakhtawar Amin Hospital Multan were included. The study duration was from June 01, 2018 to May 31, 2020. Patients were first investigated on TVS examination to diagnose endometriosis. Afterwards, diagnostic laparoscopy was performed in all patients to confirm the diagnosis of endometriosis. Accuracy of TVS was determined in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).&lt;br /&gt;&lt;strong&gt;Results:&lt;/strong&gt; Mean age of the patients was 31.7 &amp;plusmn; 7.4 years. Most common presenting complaint was dysmenorrhea in 89 (75.4%) patients followed by dyspareunia in 36 (30.5%), chronic pelvic pain in 30 (25.4%) patients and subfertility in 18 (15.3%) patients. On TVS, endometriosis was diagnosed in 69 (58.5%) patients. While on diagnostic laparoscopy, endometriosis was diagnosed in 75 (63.6%) patients.The sensitivity of TVS in diagnosis of endometriosis was calculated as 82.7%, specificity as 83.7%, PPV as 89.9% and NPV as 73.5%.&lt;br /&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; TVS appears to be the alternative and safe modality for diagnosis of endometriosis. It can be used as an alternative to diagnostic laparoscopy for the early diagnosis of endometriosis. It has a good sensitivity and specificity for diagnosis of endometriosis.&lt;/p&gt;

DIAGNOSTIC VALUE OF TRANSVAGINAL ULTRASOUND SONOGRAFY IN THE DIAGNOSTICS OF ENDOMETRIAL POLYPS

The aim of research is to determine the diagnostic accuracy, sensitivity, specificity, predictive value of positive and negative results of ultrasound diagnostics of endometrial polyps using pathohistological verification of the results of transvaginal ultrasound (TUS).Materials and research methods. A retrospective study of all case histories of patients who underwent hysteroscopy or fractional diagnostic curettage from January 2017 to January 2018 in the city maternity hospital in Zaporozhye was carried out. A total of 266 histories were selected, but 110 stories of patients were excluded from the analysis for whom the procedure was performed for another pathology of the uterus (submucous myoma, synechiae of the uterine cavity) or who did not have histological data that could serve as a comparison criterion. endometrial polyps were diagnosed in 156 cases. A comparative analysis of preoperative diagnosis based on the results of TUS and postoperative diagnosis based on the results of histopathological examinationResearch results and their discussion. The sensitivity, specificity, predictive value of positive and negative results, and the accuracy of TUS in the diagnosis of endometrial polyps were 69%, 51%, 73%, 46% and 63%, respectively. This retrospective study made it possible to obtain data on the insufficient accuracy of ultrasound diagnostics of endometrial polyps, since in 26% of women this diagnosis was not confirmed histologically, that is, there was a false positive result, and in 54% of cases, the polyp was not detected at the preoperative stage, that is, a false negative was noted. result.Conclusions. The results of the study indicate the disputability of the issue of the priority and accuracy of sonography in the diagnosis of endometrial polyps, the validity of performing further invasive procedures on the basis of TUS only, and also dictates the need for additional analysis, taking into account the qualifications of ultrasound diagnostics specialists.

Transvaginal Ultrasonography and Saline Infusion Sonography Compared to Hysteroscopy for Diagnosis of Intracavity Lesion: A 4-Year Experience in Suburban Referral Hospital

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. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy

Question Mark Sign and Transvaginal Ultrasound Uterine Tenderness for the Diagnosis of Adenomyosis: A Prospective Validation.

To evaluate the diagnostic accuracy of the classic ultrasound (US) signs of adenomyosis, the question mark sign and transvaginal ultrasound (TVUS) uterine tenderness, in the diagnosis of adenomyosis. This was a prospective study including 78 patients waiting for hysterectomy for uterine benign diseases and undergoing preoperative US examinations to evaluate all criteria for US diagnosis of adenomyosis as reported by the consensus statement of the Morphological Uterus Sonographic Assessment group. A US diagnosis of adenomyosis was made in the presence of 2 or more Morphological Uterus Sonographic Assessment features. Moreover, the question mark sign and TVUS uterine tenderness were evaluated. Ultrasound features were compared with the histologic examination, which was considered the reference standard for the diagnosis of adenomyosis. The Cohen κ coefficient was used to measure the accordance between US and histologic results. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each US feature were calculated. The prevalence of adenomyosis in the sample was 33.3%. The sensitivity, specificity, PPV, NPV, and accuracy of TVUS in the diagnosis of adenomyosis were 77%, 96%, 91%, 89%, and 90%, respectively. Myometrial heterogeneity was the most frequently encountered feature (100%) but showed low specificity (7%). The question mark sign and TVUS uterine tenderness showed sensitivity, specificity, PPV, NPV, and accuracy of 41%, 96%, 83%, 77%, and 69% and 69%, 65%, 66%, 81%, and 67%. The question mark sign and TVUS uterine tenderness are useful tools for the diagnosis of adenomyosis.

Accuracy of Transvaginal Ultrasound in Prediction of Latency Period in Women with Preterm Premature Rupture of Membranes

Background: Preterm prelabor rupture of membranes (PPROM) is a major cause of Pretem Birth (PTB), Pretem Birth (PTB) is the most significant cause of perinatal morbidity and mortality worldwide. Cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) have been postulated in several studies to have an important role in prediction of PTB. Up to our knowledge, this is the first study that combines the three cervical parameters in prediction of latency period in women with PPROM. Aim of the Work: To assess the accuracy of cervical length, posterior uterocervical angle and anterior uterocervical angle in prediction of latency period in women with Preterm prelabor rupture of membranes. Subjects and Methods: A Prospective cohort study on 205 women with PPROM was held at Ain Shams University Maternity Hospital, a transvaginal ultrasound was performed to measure cervical length, posterior uterocervical angle, anterior uterocervical angle. Results: A total of 205 pregnant women with PPROM were included in this study, the latency grade was within 2 days in 57 (27.8%) of cases while was after 2 days in 148 (72.2%) of cases. As regards cervical length cut-off value 25.0 mm, sensitivity was 78.9%, specificity was 65.5%, posterior uterocervical angle cut-off value 108.0°, sensitivity was 93.0%, specificity was 60.1%, and anterior uterocervical angle cut-off value 106.0°, sensitivity was 93.0%, specificity was 71.6%. Conclusion: The combination of cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) measurements greatly predicts the latency period in women with PPROM, and Anterior uterocervical angle (AUCA) ≥ 106.0° had the highest diagnostic value in predicting latency period within two days.

Agreement between transvaginal ultrasound and saline contrast sonohysterography in evaluation of cesarean scar defect

Objectivesto assess the agreement between saline contrast sonohysterography (SCSH) and transvaginal sonography (TVS) in the evaluation of cesarean section scar defect (CSD) regarding its width, depth, and shape and also in assessing the anterior myometrium, and residual myometrium related to the scar. Material and methodsa prospective study during the period between August 2017 and January 2018 was conducted in which 102 consecutive participants underwent primary cesarean section in Ain Shams University Maternity Hospital were assessed six weeks after CS to evaluate for CSD presence by using both SCSH and TVS. ResultsCSD could be detected only in 59.8% of women by TVS and 70.5% by SCSH with good agreement strength (Cohen kappa = 0.805). TVS was 84.72% sensitive and 100.00% specific in identifying CSD diagnosed by SCSH. The PPV, NPV, and accuracy of TVS were 100.00%, 73.17%, and 89.21%, respectively.The mean anterior myometrial thickness (AMT) did not differ when assessed by both TVS and SCSH, while the mean niche width was 2.56 ± 1.98 mm with SCSH compared to 2.17 ± 1.63 mm with TVS(r = 0.954), and its mean depth was 2.76 ± 2.02 mm for SCSH and 1.57 ± 1.51 mm in TVS(r = 0.812). The mean residual myometrium was 10.09 ± 2.74 mm in SCSH while was 11.18 ± 2.50 mm for TVS(r = 0.914) Conclusioncesarean scar defects in non-pregnant women are better evaluated at SCSH than at unenhanced TVS as more defects detected by SCSH and better evaluation of its shape, borders and size.

Accuracy of Physical Examination, Transvaginal Sonography, Magnetic Resonance Imaging, and Rectal Endoscopic Sonography for Preoperative Evaluation of Rectovaginal Endometriosis.

The aim of this study was to compare the effectiveness of physical examination, transvaginal sonography, magnetic resonance imaging, and rectal endoscopic sonography for the identification of rectovaginal endometriosis and potential rectal infiltration. Women with suspected rectovaginal endometriosis underwent physical examination, transvaginal sonography, magnetic resonance imaging, and rectal endoscopic sonography. Evaluation was performed for the presence of rectovaginal endometriotic foci and rectal infiltration. The findings obtained with these methods were compared with those of surgical and histopathological examination. Sensitivity, specificity, positive predictive values, and negative predictive values were evaluated for each method. Rectovaginal endometriosis was histologically confirmed in 21 (72.4%) of 29 women. With respect to diagnosis of rectovaginal endometriosis, the sensitivity, specificity, and accuracy of physical examination were 95.2%, 62.5%, and 86.2%; those of transvaginal sonography were 42.9%, 87.5%, and 55.2%; those of magnetic resonance imaging were 90.5%, 87.5%, and 89.7%; and those of rectal endoscopic sonography were 81.0%, 75.0%, and 79.3%, respectively. With respect to identification of rectal infiltration, the sensitivity, specificity, and accuracy of transvaginal sonography were 26.7%, 85.7%, and 55.2%; those of magnetic resonance imaging were 73.3%, 92.9%, and 82.8%; and those of rectal endoscopic sonography were 86.7%, 85.7%, and 86.2%, respectively. Magnetic resonance imaging combined with physical examination seem to be the main approach for the presurgical assessment of rectovaginal endometriosis. Rectal endoscopic sonography is a worthwhile method for the diagnosis of rectal infiltration.

The comparison of transvaginal ultrasonography and hysteroscopy in women with abnormal uterine bleeding: A single center experience

Aim: The aim of this study is to compare the diagnostic accuracy of transvaginal ultrasonography and hysteroscopy in the detection of intracavitary abnormalities that presented with abnormal uterine bleeding. Material and Methods: 216 women with uterine bleeding involve in this study. In this retrospective study, the diagnostic accuracy of transvaginal ultrasonography and hysteroscopy were compared to their corresponding pathology results in both prepostmenopausal (n:145) and postmenopausal (n:71) women. To compare these three methods more reliably, we used Kappa analyses. Results: In postmenopausal group with endometrial polyp and myomas; sensitivity of transvaginal ultrasonography is 68.2% to 40% dilatation & curettage, specificity is 33.3% to 97% and Kappa value is 0.016 to 0.407. Sensitivity of hysteroscopy is 97.7% to 40% dilatation & curettage, specificity is 74.1% to 100% and Kappa values is 0.75 to 0.553. Specificity of transvaginal ultrasonography is 98.3% to hysteroscopy, specificity of transvaginal ultrasonography is 98.1% to dilatation & curettage, sensitivity of hysteroscopy is 47.1% and specificity is 90.7% to dilatation & curettage and Kappa value is 0.411 with normal patients in the same group. Conclusion: In postmenopausal patients transvaginal ultrasonography has a high chance of detecting when there is an endometrial pathology. Transvaginal ultrasonography is not sensitive enough to use solely in order to exclude polyps and fibroids in abnormal uterin bleeding. Therefore, hysteroscopy can be applied even if transvaginal ultrasonography is normal in these patients.

Concomitant Saline Infused Sonohysterography and Endometrial Sampling of Intrauterine Pathology Using SonoSure Device

Saline Infusion Sonohysterography (SIS) has become a routine diagnostic tool for the female reproductive tract and provides better visualization and detection of intrauterine pathology, enhancing the diagnostic accuracy of Transvaginal Ultrasound (TVS) in women with Abnormal Uterine Bleeding (AUB). While saline infusion sonohysterography and Endometrial Biopsy (EMB) are routinely used in the workup for AUB, few providers perform these procedures concurrently.

Transvaginal sonographic evaluation at different menstrual cycle phases in diagnosis of uterine lesions

Purpose:Intrauterine lesions (IULs) are a common finding in women of reproductive age, particularly infertile women. Transvaginal sonography (TVS) is a popular tool for IUL detection, but there are conflicting data with respect to its accuracy.Methods:Five hundred and six women were enrolled into the study. Of these, 496 underwent hysterosalpingography and subsequent TVS six different times during the course of their menstrual cycle. If a lesion was detected, it was further evaluated by sonohysterography (SHG) and hysteroscopy.Results:Of 496 women, 41 were shown to have IULs by TVS and those lesions were confirmed in 39 by SHG and hysteroscopy. All 39 lesions were detectable during the ovulatory and early luteal phase (days 16–19) of the menstrual cycle. Accuracy of TVS during different phases was largely dependent on the size of the lesion. TVS falsely detected two lesions and missed fine adhesions in two patients.Conclusion:Accuracy of TVS in detection of IULs is highly dependent on the menstrual cycle phase, with the ovulatory and early luteal phase being the optimal time for this examination.

OC11.05: Accuracy of transvaginal sonography and contrast‐enhanced MR‐colonography for the pre‐surgical assessment of deep pelvic endometriosis

OC11.05: Accuracy of transvaginal sonography and contrast‐enhanced MR‐colonography for the pre‐surgical assessment of deep pelvic endometriosis