Diagnostic accuracy of sonohysterography, hysterosalpingography and diagnostic hysteroscopy in diagnosis of arcuate, septate and bicornuate uterus
Diagnostic accuracy of sonohysterography, hysterosalpingography and diagnostic hysteroscopy in diagnosis of arcuate, septate and bicornuate uterus
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DOI：
10.1111/j.1447-0756.2010.01304.x
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发表时间：
2011-03-01
影响因子：
1.6
通讯作者：
Basta, Antoni
中科院分区：
文献类型：
--
作者：
Ludwin, Artur;Ludwin, Inga;Basta, Antoni
目的：评价超声宫腔造影术(SHG)、子宫输卵管造影术(HSG)和诊断性宫腔镜检出子宫异常的准确性，并评价其在弓形、纵隔和双角子宫鉴别诊断中的作用。方法：83例有反复自然流产或不孕史且初诊为子宫异常的妇女。诊断工作由SHG、HSG和DH组成。为了评估这些方法的准确性，所有患者都进行了宫腔镜术以确定最终诊断。结果：在子宫异常的整体诊断中，SHG诊断正确率为95.2%，相关系数为0.873(P<；0.001)是一种较好的工具(SHG(AUC)=0.924，DHAUC=0.761，P=0.008)，而SHG与HSG和DH与HSG之间没有显著差异。双角子宫(SGH(AuC)=1.000比DHACC=0.707；P<；0.001和SHG(Acc)=1.000对HSG(Auc)=0.790)对隔(AUC)=1.000比DHAUC=0.816 P&t；0.001和SHG(AUC)=1.000对HSG(AUC)=0.818；P<；0.001；P=0.002)。结论：SHG是一种非侵入性、经济有效的方法，适用于门诊环境，在识别子宫异常，特别是纵隔和双角子宫方面具有很高的准确性。
Aim:To evaluate the diagnostic accuracy of sonohysterography (SHG), hysterosalpingography (HSG) and diagnostic hysteroscopy (DH) in uterine anomaly detection and to assess the role of these various modalities in the differential diagnosis of arcuate, septate and bicornuate uteri.Methods:Eighty-three women, with a history of recurrent spontaneous abortions or infertility and initial diagnosis of uterine anomaly were included in the study. Diagnostic work-up comprised of SHG, HSG and DH. To assess the accuracy of these methods all the patients underwent hysterolaparoscopy to establish the final diagnosis. The correlation between the results of each method was evaluated and diagnostic accuracy of each method was assessed in the whole group of women as well as in subgroups of arcuate, septate and bicornuate uteri using receiver operator curve (ROC) method by estimating the area under the curve (AUC).Results:In the overall diagnosis of uterine anomalies, SHG with accuracy of 95.2% and correlation index of 0.873 (P < 0.001) proved to be a significantly better tool compared to DH (SHG(AUC) = 0.924 versus DHAUC = 0.761 P = 0.008), while no significant differences were observed between SHG versus HSG and DH versus HSG. SHG showed significantly higher accuracy (100.0%) compared to DH (80.7%) and HSG (80.7%) in differentiation of a septate (SHG(AUC) = 1.000 versus DHAUC = 0.816 P < 0.001 and SHG(AUC) = 1.000 versus HSG(ACC) = 0.818; P < 0.001) and bicornuate uterus (SGH(AUC) = 1.000 versus DHACC = 0.707; P < 0.001 and SHG(ACC) = 1.000 versus HSG(AUC) = 0.790; P = 0.002).Conclusion:SHG is a noninvasive, cost-effective method available in an outpatient setting that is highly accurate in identifying uterine anomalies, in particular septate and bicornuate uterus.