Diagnostic Value of Transvaginal and Hysteroscopic Ultrasound in Comparison with Pathology in the Diagnosis of Endometrial Lesions in Women with Abnormal Uterine Bleeding

Abstract

Background: The aim of this study was to determine the diagnostic value of transvaginal ultrasound and hysteroscopy findings compared with pathology in the diagnosis of endometrial lesions in women with abnormal uterine bleeding. Methods: In a cross-sectional study, 106 pre- and postmenopausal women, complained of abnormal uterine bleeding, underwent transvaginal ultrasound and hysteroscopy, and the accuracy of the findings of this diagnostic duality was assessed by endometrial sampling in the operating room. Finally, the agreement between ultrasound and hysteroscopy was examined, and the diagnostic value criteria of both ultrasound and hysteroscopy were calculated according to the pathological findings. Findings: The agreement ratio between ultrasound and hysteroscopy in the normality of endometrial thickness was 69. On the other hand, the agreement between the two methods was upper in postmenopausal women than in perimenopausal women. Ultrasound did not have a high sensitivity and specificity for myoma diagnosis. However, the positive predictive value of ultrasound in polyp diagnosis (82.7) and its negative predictive value in myoma diagnosis (91.7) were high. Hysteroscopy was highly sensitive to polyp and myoma detection. Conclusion: There is a favorable agreement between transvaginal and hysteroscopic ultrasound to determine the normality of the endometrium. Hysteroscopy has high diagnostic value criteria for the diagnosis of these lesions. However, since hysteroscopy is an invasive procedure, the use of transvaginal ultrasound to screen women with abnormal uterine bleeding is justified. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.