Comparison of diagnostic methods for evaluation of postmenopausal bleeding

Area of Science:

• Gynecology
• Diagnostic Imaging
• Pathology

Background:

• Postmenopausal bleeding (PMB) requires accurate diagnosis of endometrial cavity lesions.
• Histopathology is the gold standard for evaluating endometrial abnormalities.

Purpose of the Study:

• To compare the diagnostic accuracy of saline infusion sonohysterography (SIS), transvaginal ultrasonography (TVUSG), and hysteroscopy (H/S) for endometrial lesions in PMB patients.
• To evaluate sensitivity, specificity, and predictive values of each imaging modality against histopathologic findings.

Main Methods:

• A study included 47 patients aged 43-76 with PMB.
• Endometrial sampling was performed using fractioned curettage (F/C) and H/S guided biopsy.
• Diagnostic accuracy parameters were calculated for TVUSG, SIS, and H/S.

Main Results:

• Hysteroscopy (H/S) demonstrated 100% sensitivity and 77.7% specificity.
• Saline infusion sonohysterography (SIS) showed 88.8% sensitivity and 60.7% specificity.
• Transvaginal ultrasonography (TVUSG) had the lowest accuracy with 44.4% sensitivity and 25% specificity.

Conclusions:

• SIS is a highly effective method for assessing endometrial cavity lesions in PMB patients.
• SIS demonstrates superior diagnostic performance compared to TVUSG.
• SIS is as effective as H/S in the evaluation of endometrial pathology.