Comparison of transvaginal sonography, saline infusion sonography, and hysteroscopy in premenopausal women with abnormal uterine bleeding.

Saline infusion sonography (SIS) is a relatively new technique in the evaluation of abnormal uterine bleeding. We compared the diagnostic accuracy of SIS with that of transvaginal sonography (TVS) in the detection of intracavitary abnormalities in premenopausal women with abnormal uterine bleeding. In this prospective study, consecutive premenopausal women who underwent a hysteroscopy for abnormal uterine bleeding also underwent TVS and SIS. The findings at TVS and SIS were compared with the hysteroscopic and histologic findings. Sensitivity, specificity, and likelihood ratios were calculated. Receiver operating characteristic curves were constructed to assess the performance of endometrial thickness measured using TVS. Sixty-two patients were included in the study. TVS demonstrated 60% sensitivity in directly visualizing intracavitary abnormalities and 93% specificity. The likelihood ratio of the presence of an intracavitary abnormality was 8, and the likelihood ratio of the absence of an intracavitary abnormality was 0.43. Defining an abnormality at TVS as direct visualization of an intracavitary abnormality or an endometrial thickness greater than 5 mm, TVS had an 85% sensitivity and a 21% specificity, with corresponding likelihood ratios of 1.1 and 0.71, respectively. For SIS, the sensitivity, specificity, and likelihood ratios of the presence and absence of intracavitary abnormalities were 88%, 95%, 10, and 0.13, respectively. SIS is more accurate in the diagnosis of intracavitary abnormalities in premenopausal women than is TVS. An approach using endometrial thickness measurement by TVS and reserving SIS for patients who have an endometrial thickness greater than 5 mm or an intracavitary abnormality visualized by TVS would be the most effective method to reduce the number of hysteroscopies.

de Vries LD ，Dijkhuizen FP ，Mol BW ，Brölmann HA ，Moret E ，Heintz AP ... -  《JOURNAL OF CLINICAL ULTRASOUND》

Comparison of transvaginal ultrasonography and saline infusion sonography for the detection of intracavitary abnormalities in premenopausal women.

Dijkhuizen FP ，De Vries LD ，Mol BW ，Brölmann HA ，Peters HM ，Moret E ，Heintz AP ... -  《ULTRASOUND IN OBSTETRICS & GYNECOLOGY》

Three-dimensional saline infusion sonography compared to two-dimensional saline infusion sonography for the diagnosis of focal intracavitary lesions.

Nieuwenhuis LL ，Hermans FJ ，Bij de Vaate AJM ，Leeflang MM ，Brölmann HA ，Hehenkamp WJ ，Mol BWJ ，Clark TJ ，Huirne JA ... -  《Cochrane Database of Systematic Reviews》

Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in the evaluation of uterine cavity pathologies.

Cepni I ，Ocal P ，Erkan S ，Saricali FS ，Akbas H ，Demirkiran F ，Idil M ，Bese T ... -  《AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY》

Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding.

Dueholm M ，Forman A ，Jensen ML ，Laursen H ，Kracht P ... -  《ULTRASOUND IN OBSTETRICS & GYNECOLOGY》