Detection of endometrial pathology using saline infusion sonography versus gel instillation sonography: a prospective cohort study
| Autor: | Sabine Van Huffel, Dirk Timmerman, E. Werbrouck, Joan Veldman, Jan Luts, Thierry Van den Bosch, Dominique Van Schoubroeck |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Hysteroscopy Sodium Chloride Cohort Studies Endometrium Polyps Predictive Value of Tests medicine Humans Prospective Studies Prospective cohort study Ultrasonography Hysterectomy medicine.diagnostic_test Leiomyoma business.industry Obstetrics and Gynecology Reproducibility of Results Anatomical pathology Middle Aged medicine.disease Confidence interval Surgery Endometrial hyperplasia Endometrial Neoplasms Reproductive Medicine Predictive value of tests Uterine Neoplasms Feasibility Studies Female business Gels Cohort study |
| Zdroj: | Fertility and sterility. 95(1) |
| ISSN: | 1556-5653 |
| Popis: | Objective To compare saline infusion sonography (SIS) with gel instillation sonography (GIS) in terms of feasibility and diagnostic accuracy. Design Prospective cohort study. Setting Leuven University bleeding clinic. Patient(s) A total of 804 patients: two consecutive cohorts of 402 women undergoing SIS or GIS. Intervention(s) Vaginal ultrasound (n = 804) followed by SIS (n = 402) or GIS (n = 402); office hysteroscopy in 685 patients, and endometrium sampling in 487 patients; surgery in 274 women: operative hysteroscopy (n = 230) or hysterectomy (n = 44). Main Outcome Measure(s) Patients' characteristics, technical failure rates, and final diagnosis. Pathology was defined as endometrial hyperplasia, polyp, cancer, or intracavitary myomas. Result(s) The technical failure rate (difference between proportions and confidence interval) was 5.0% for SIS versus 1.8% for GIS, respectively (3.21; [0.69–5.95]). Failure due to inadequate distension was 1.5% versus 0.3% for SIS and GIS, respectively (1.25; [–0.16–2.99]). Pathology was diagnosed in 180 patients (49%) of the SIS group versus 147 patients of the GIS group (40.2%) (8.88; [1.69–15.95]). The sensitivity was 77.8% and 85.0%, respectively (NS). The negative predictive value was 79.1% for SIS and 88.6% for GIS (9.54; [2.17–16.89]). Conclusion(s) Gel instillation sonography is a feasible, accurate alternative for SIS in the evaluation of women with abnormal bleeding, and has fewer technical failures. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|