Comparison of ultrasound with hysteroscopic and histological findings for intrauterine assessment

Abstract

Introduction. Hysteroscopy with biopsy is a common diagnostic and therapeutic method in gynaecology. Its use is preceded by ultrasound examination. The success rate of predicting intrauterine findings based on ultrasound has not been assessed in the Czech Republic for a long time. In the meantime, there have been technological improvements in ultrasound devices. Method. Patients indicated for hysteroscopy underwent ultrasound examination and their medical history was recorded. The percentage agreement between ultrasound and histopathological findings was assessed. The secondary goal was to find an easier way of describing ultrasound findings in gynaecological practice. Results. The study comprised 255 patients. In 15 cases, endometrial carcinoma was confirmed by hysteroscopy and histopathological examination. Of these, malignancies were suspected based on previous ultrasound scans in 11 patients. In 95 cases, intrauterine polyps were detected. The success rate for predicting polyps by ultrasound examination was 65.1%. The agreement between ultrasound and hysteroscopic/histopathological findings was 72%. The secondary goal of making the description of the uterine cavity easier was not fulfilled. The prediction percentages for the criteria were low. The incidence of pathological findings in ultrasound findings labelled as anechogenic was 4.8%, suggesting a high negative predictive value. Conclusion. In spite of the better resolution of new ultrasound devices, their predictive value remains limited. Findings that are suspicious in ultrasound should be confirmed by hysteroscopy with biopsy.

Comparative retrospective study on transvaginal sonography versus office hysteroscopy in the diagnosis of endometrial pathology among different subgroups

“…19 In detecting endometrial pathology in the general population, TVS demonstrated moderate diagnostic accuracy compared to hysteroscopy, findings that are consistent with that of international literature. Scientific evidence was also included [23][24][25][26][27][28][29][30][31] to check our results with the ones obtained by similar international studies. It seems that through the years HSC is taking over TVS.…”

Should outpatient hysteroscopy be used in preference to transvaginal ultrasound to identify endometrial pathology in premenopausal women with heavy menstrual bleeding? Revisiting NICE Guideline 88

“…Only a minority (1%) 17,18,19 of premenopausal patients will have premalignant or malignant disease. 20 This study identified one case of malignancy in a 53-year-old woman who was perimenopausal, which is similar to other studies.…”

Accuracy of Office Hysteroscopy in Diagnosis of Endometrial Pathologies Compared to Ultrasound and Histopathology in Baghdad Teaching Hospital

“…8 Furthermore, our study reveals a sensitivity of 84.2% and specificity of 92% for hysteroscopy in diagnosing hyperplasia compared to TVU 80.7% and 90%, respectively, and not surprisingly both hysteroscopy and TVU showed low sensitivity of 50% and 34% in detecting endometrial cancer compared to the histopathologic results and these findings were comparable to the results obtained by Krampl et al, who reported a sensitivity of 33% for TVU and 22% for hysteroscopy and a specificity of 88% and 87%, respectively, in diagnosing hyperplasia and malignancy. 9 According to Balić D and Balić A, the reason behind the discrepancy of results between the TVU and hysteroscopy findings might be due to the use of a high frequency US probe and better resolution images. As a result, the echogenic zones appeared as small polyps, 3 while a study conducted in Italy suggests the risk or error during TVU and office hysteroscopy subjected to operator's skills and experience.…”