Comparison of diagnostic accuracy of saline infusion sonohysterography, transvaginal sonography and hysteroscopy

Abstract

We aimed to compare the accuracy of transvaginal sonography (TVS), saline infusion sonohysterography (SIS) and hysteroscopy (HS) for uterine pathologies among infertile women. A total of 346 patients were selected for operative hysteroscopy, following SIS after TVS. SİS was performed with a Cook Soft 500 IVF catheter. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated to compare the accuracy of TVS, SIS and hysteroscopy for uterine abnormalities. SIS showed a sensitivity of 87%, specificity of 100% and PPV of 100% for endometrial hyperplasia, and a sensitivity and NPV of 100% for polypoid lesions. For submucosal myoma SIS showed a sensitivity of 99% with PPV of 96%. Hysteroscopy had a sensitivity, specificity, PPV and NPV of 98%, 83%, 96% and 91%, respectively for overall uterine pathologies. Finally, SIS seems to be superior to TVS, for uterine pathologies, with respect to hysteroscopy as the gold standard.

Saline infusion sonography in evaluation of uterine cavity abnormalities in infertility: a comparative study

“…In a study by Bingol et al the abnormalities detected in endometrial cavity were endometrial polyps 31.5%, submucous myoma 29.5%, endometrial hyperplasia in 23.7% and intrauterine adhesions in 12.4%. 10 The incidence of abnormalities were polyp 35.7%, sub mucosal myoma 12.5%, Ashermanns syndrome 3.6%, septate uterus 14.3% and endometrial hyperplasia 33.9% in the study by Devleta and Adem. 11 The high incidence of intrauterine adhesion in the present study could be due to high prevalence of tuberculosis in a developing country like India.…”

Usefulness of saline infusion sonohysterography and feeding artery imaging in endometrial polyp diagnosis

“…The benefits of transvaginal sonography with color Doppler, saline infusion sonohysterography and hysteroscopy are highly supported [8,9]. Transvaginal sonography is a widely accepted method of endometrial evaluation and many authors believe that normal sonography endometrial imaging sufficiently establishes absence of pathology in perimenopausal patients with abnormal uterine bleeding [10][11][12].…”

“…Poorer SIS sensitivity and specificity have been reported [9,18,19]. In the group of 105 patients sonohysteroscopy failed to detect endometrial polyps in 30 cases [18], SIS may also lead to erroneous diagnosis of blood clots as endometrial polyps [20].…”

Diagnostic Accuracy of Saline-Contrast Sonohysterography Guided Biopsy versus Office Biopsy in Endometrial Pathology: an Interventional Study

“…In contrast, SCSH GB has been proven to be a safe, cost-effective and comparative alternative diagnostic tool with a high level of accuracy and reliability in the initial diagnosis of women with AUB. Therefore, SCSH GB can reduce the number of patients undergoing hysteroscopy [21,22]. We recruited a larger sample size than those of previous studies and thus provided more reliable results [1,20].…”