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Published on: August 2, 2024
[Sensitivity and specificity of hysterosonography in endometrial abnormalities in asymptomatic postmenopausal women]
Sonia Tamanaha1, José Mendes Aldrighi, Roberto Euzébio dos Santos
1Departamento de Obstetricia e Ginecologia, Irmandade da Santa Casa de Misericórdia, São Paulo. sonia.tamanaha@ig.com.br
Background:
To estimate sensitivity and specificity of hysterosonography for diagnosis of endometrial cavity abnormalities. The gold-standard was hysteroscopy; to compare the agreement between ultrasonographic, hysterosonographic and hysteroscopic findings using the KIA (Kappa Index Agreement).
Methods:
Fifty asymptomatic postmenopausal women that had a suspicion of endometrial abnormalities based upon transvaginal ultrasonography were studied. Hysterosonography, diagnostic hysteroscopy and oriented biopsy were performed and the Kia was used to compare results.
Results:
The most frequent abnormalities were polyps (58%), synechiae (20%), submucous myoma (12%) and endometrial thickening (6%). The uterine cavity was considered normal in 4% of the evaluations by hysteroscopy. The sensitivity of hysterosonography to diagnose polyps was of 89.7%, the specificity of 81.0% and the KIA of 71.1%. For synechia sensitivity of hysterosonography was of 80%, specificity of 100% and the KIA of 86.5%; for submucous myoma sensitivity was of 83.3%; specificity of 97.7% and the KIA of 81.1%, and for endometrial thickening, sensitivity was of 33.3%, specificity of 89.4% and the KIA of 15.5%.
Conclusion:
Hysterosonography showed very good agreement with hysteroscopy for the diagnosis of synechiae and submucous myomas; good agreement for polyps and poor agreement for endometrial thickening. Based upon this data hysterosonography may be deemed a simple, efficient, and accurate method for the evaluation of the uterine cavity in the postmenopausal period.
