Comparison of transvaginal ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding
Comparison of transvaginal ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding
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DOI：
10.3348/kjr.2004.5.1.39
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发表时间：
2004-01-01
影响因子：
4.8
通讯作者：
Lee, SH
中科院分区：
文献类型：
--
作者：
Ryu, JA;Kim, B;Lee, SH
目的：评估子宫超声检查（HS）作为异常子宫出血患者筛查方法的效用。材料与方法：我们回顾性分析了 105 例经病理确诊的患者的经阴道超声检查（TVS）和 HS。所有 105 名患者均在同一天接受了 TVS 和 HS 的初步评估。 TVS和HS检查将子宫内膜空洞病变分为弥漫性增生、子宫内膜息肉、子宫内膜癌、子宫粘连和粘膜下肌瘤。进行宫腔镜活检（n=35）、刮宫术（n=60）或子宫切除术（n=10），TVS和HS检查结果与病理结果相关。结果：TVS的敏感性和特异性分别为79.0%和45.8%，HS的敏感性和特异性分别为95.1%和83.3%。 TVS 的阳性预测值为 83.0%，阴性预测值为 39.3%，HS 的阳性预测值为 95.1%，阴性预测值为 83.3%。 27例显示TVS与HS不一致，8例显示HS与病理诊断不一致。结论：TVS是评估子宫内膜空洞病变的敏感方法，但它往往不能为医生提供足够的诊断信息。 HS比TVS具有更高的敏感性、特异性以及阳性和阴性预测值，可以更好地用于评估异常子宫出血患者。
Objective: To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding.Materials and Methods: We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings.Results: The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1 % and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1 % and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis.Conclusion: TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.