The role of transvaginal ultrasonography and outpatient diagnostic hysteroscopy in the evaluation of patients with menorrhagia
The role of transvaginal ultrasonography and outpatient diagnostic hysteroscopy in the evaluation of patients with menorrhagia
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DOI：
10.1093/humrep/12.8.1768
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发表时间：
1997-08-01
影响因子：
6.1
通讯作者：
Crosignani, PG
中科院分区：
文献类型：
--
作者：
Vercellini, P;Cortesi, I;Crosignani, PG
为了验证经阴道超声诊断宫腔内疾病的可靠性和评价粘膜下肌瘤的可操作性，以及宫腔镜检查治疗月经过多的可行性、可接受性和有效性，我们对793例平均年龄+/-SD为41.5+/-7.8岁的妇女进行了为期5年的前瞻性研究，所有因月经过多合并子宫体积过多的患者(包括12周后接受全面体检、经阴道超声检查和门诊宫腔镜检并子宫内膜活检的患者，23例(2.9%)因不耐受或因出血过多而不满意)进行了前瞻性研究。只有28名妇女(3.5%)表示她们拒绝接受手术，因为她们想象到了疼痛，观察到1例盆腔炎。与宫腔镜检查相比，经阴道超声诊断宫内异常的敏感性为96%，特异性为86%，阳性预测值为91%，阴性预测值为94%。超声诊断宫腔内可手术的粘膜下肌瘤的敏感性、特异性、阳性预测值和阴性预测值
To verify the reliability of transvaginal ultrasonography in diagnosing intrauterine disease and in evaluating the operability of submucous myomas and to determine the feasibility, acceptability and validity of hysteroscopy for menorrhagia, we performed a prospective 5 year study on 793 women of mean age +/- SD of 41.5 +/- 7.8 years, All the patients referred for excessive menstrual bleeding with uterine volume (12 week pregnancy who underwent complete physical examination, transvaginal ultrasonography and outpatient hysteroscopy with endometrial biopsy were included in the study, Outpatient hysteroscopy was not completed due to intolerance or was unsatisfactory due to excessive bleeding in 23 cases (2.9%), Only 28 women (3.5%) declared they mould have refused the procedure had they imagined the pain involved, One case of pelvic infection was observed, Compared with hysteroscopy, transvaginal ultrasonography had 96% sensitivity, 86% specificity, 91% positive predictive value and 94% negative predictive value in the diagnosis of intrauterine abnormality, The sensitivity, specificity, positive and negative predictive values of ultrasonography in identifying submucous myomas operable hysteroscopically (intramural extension