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Sonohysterography of the uterine cavity: preliminary investigations
P Gaucherand1, J M Piacenza, B Salle
1Gynaecology and Obsterics Department, Hôpital Croix-Rousse, Lyon, France.
Objective:
To compare sonohysterography (SH), in the exploration of the uterine cavity, with classical transvaginal sonography (TVS), hysterography (HSG), and hysteroscopy.
Study Design:
104 consecutive patients evaluated for uterine disorders underwent both TVS and SH. SH was obtained by distension of the uterine cavity with the instillation of an isotonic saline solution; 36 patients also underwent HSG; 82 women underwent surgery. Histologic findings were considered as gold standard. The criteria used to compare these methods were sensitivity, specificity, and negative and positive predictive values (NPV, PPV) for identifying pathology.
Results:
3 instillation failures occurred. SH was found to be more effective (sensitivity 94%, specificity 98%) than HSG (sensitivity 67%, specificity 94%). The difference between TVS and SH was less marked, SH showing some superiority (sensitivity 88%, specificity 98%) to TVS (sensitivity 77%, specificity 93%).
Conclusion:
SH represents an improvement over conventional TVS and is fully capable of replacing HSG for the study of the uterine cavity.