Walid El-Sherbiny1, Akmal El-Mazny2, Nermeen Abou-Salem2, Wael Sayed Mostafa2. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: wssherbiny@kasralainy.edu.eg. 2. Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Abstract
STUDY OBJECTIVE: To compare 2-dimensional sonohysterography (2D SHG) vs 3-dimensional sonohysterography (3D SHG) using saline solution infusion, with outpatient hysteroscopy as the gold standard, for evaluation of the uterine cavity in women of reproductive age. DESIGN: Comparative observational cross-sectional study (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: One hundred twenty women of reproductive age with abnormal uterine bleeding, infertility, or recurrent pregnancy loss and with clinically and/or ultrasongraphically suspected intrauterine lesions. INTERVENTIONS: All patients underwent 2D SHG and 3D SHG using saline solution infusion followed by outpatient hysteroscopy. Sonographic findings were compared with hysteroscopic findings. MEASUREMENTS AND MAIN RESULTS: For 2D SHG, sensitivity was 71.2%; specificity, 94.1%; positive predictive value, 90.2%; negative predictive value, 81.0%; and overall accuracy, 84.2%. For 3D SHG, sensitivity was 94.2%; specificity, 98.5%; positive predictive value, 98.0%; negative predictive value, 95.7%; and overall accuracy, 96.7%. Thus, 3D SHG was superior to 2D SHG (p = .02) and comparable with outpatient hysteroscopy (p = .12) for diagnosis of intrauterine lesions. CONCLUSION: 3D SHG can be used in the initial evaluation of the uterine cavity in women of reproductive age, with accuracy comparable to that of hysteroscopy.
STUDY OBJECTIVE: To compare 2-dimensional sonohysterography (2D SHG) vs 3-dimensional sonohysterography (3D SHG) using saline solution infusion, with outpatient hysteroscopy as the gold standard, for evaluation of the uterine cavity in women of reproductive age. DESIGN: Comparative observational cross-sectional study (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: One hundred twenty women of reproductive age with abnormal uterine bleeding, infertility, or recurrent pregnancy loss and with clinically and/or ultrasongraphically suspected intrauterine lesions. INTERVENTIONS: All patients underwent 2D SHG and 3D SHG using saline solution infusion followed by outpatient hysteroscopy. Sonographic findings were compared with hysteroscopic findings. MEASUREMENTS AND MAIN RESULTS: For 2D SHG, sensitivity was 71.2%; specificity, 94.1%; positive predictive value, 90.2%; negative predictive value, 81.0%; and overall accuracy, 84.2%. For 3D SHG, sensitivity was 94.2%; specificity, 98.5%; positive predictive value, 98.0%; negative predictive value, 95.7%; and overall accuracy, 96.7%. Thus, 3D SHG was superior to 2D SHG (p = .02) and comparable with outpatient hysteroscopy (p = .12) for diagnosis of intrauterine lesions. CONCLUSION: 3D SHG can be used in the initial evaluation of the uterine cavity in women of reproductive age, with accuracy comparable to that of hysteroscopy.
Authors: Lotte L Nieuwenhuis; Frederik Jr Hermans; A J Marjolein Bij de Vaate; Mariska Mg Leeflang; Hans Am Brölmann; Wouter Jk Hehenkamp; Ben Willem J Mol; T Justin Clark; Judith Af Huirne Journal: Cochrane Database Syst Rev Date: 2017-05-05