Clinical application of three-dimensional transvaginal ultrasonography in the diagnosis of intrauterine adhesions

Objective The present study aimed to evaluate the diagnostic accuracy of three-dimensional transvaginal ultrasonography (3D-TVS) for intrauterine adhesions (IUA). Methods We performed a retrospective cohort study. A total of 500 women aged 19 to 46 years with uterine lesions who received treatment from the Department of Obstetrics and Gynecology were enrolled. Endometrial 3D imaging was conducted to obtain the display plane and 3D-TVS parameters. Patients also underwent hysteroscopy for a definitive diagnosis. Results For diagnosing IUA, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of 3D-TVS were 98.8%, 90.8%, 91.4%, 98.7%, and 94.8%, respectively. For diagnosing a submucosal myoma, the sensitivity, specificity, PPV, NPV, and overall accuracy of 3D-TVS were 88.2%, 97.9%, 88.2%, 97.9%, and 96.4%, respectively. For diagnosing endometrial polyps, the sensitivity, specificity, PPV, NPV, and overall accuracy of 3D-TVS were 94.7%, 96.8%, 92.9%, 97.7%, and 96.2%, respectively. Conclusions Before hysteroscopy, 3D-TVS, as a method of screening, has great value for comparing differences before and after treatment, and for evaluating therapeutic effects.

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Transvaginal Ultrasonography and Saline Infusion Sonography Compared to Hysteroscopy for Diagnosis of Intracavity Lesion: A 4-Year Experience in Suburban Referral Hospital

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.06.10240 ◽

2020 ◽

Vol 103 (6) ◽

pp. 585-593

Keyword(s):

Predictive Value ◽

Final Diagnosis ◽

Saline Infusion ◽

Transvaginal Ultrasonography ◽

Histopathological Diagnosis ◽

Endometrial Polyps ◽

Saline Infusion Sonography ◽

Submucous Myoma ◽

Kappa Value ◽

Sensitivity Specificity

Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold standard for final diagnosis. Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined. Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively. Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy

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Clinical Performance of the Spot Vision Photo Screener before and after Induction of Cycloplegia in Children

Journal of Ophthalmology ◽

10.1155/2019/5329121 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Konuralp Yakar

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Clinical Performance ◽

High Specificity ◽

Screening Criteria ◽

Predictive Values ◽

Before And After ◽

Sensitivity Specificity ◽

Vision Screener

Aim. To compare the clinical performance of the Spot Vision Screener used to detect amblyopia risk factors (ARFs) in children before and after induction of cycloplegia; the children were referred because they met the screening criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods. The Spot Vision Screener and a standard autorefractometer were used to examine 200 eyes of 100 children aged 3–10 years, before and after cycloplegia induction, in terms of ARFs. Sensitivity, specificity, and positive and negative predictive values for the detection of significant refractive errors were measured using the AAPOS referral criteria. It was explored that Spot Screener data were affected by cycloplegia. The extent of agreement between cycloplegic/noncycloplegic photoscreening data and cycloplegic autorefraction measurements was assessed using Wilcoxon and Spearman correlation analyses. Results. The Spot’s sensitivity was improved from 60.9% to 85.3% and specificity from 94.9% to 87.4% with cycloplegia compared to cycloplegic standard autorefractometer results. The positive predictive value of Spot was 75.7%, and the negative predictive value was 90.4% without cycloplegia. With cycloplegia, the positive predictive value of Spot was 63.6% and the negative predictive value was 95.8%. Conclusions. The Spot Screener afforded moderate sensitivity and high specificity prior to cycloplegia. The sensitivity and negative predictive value improved after induction of cycloplegia. Examiners should be aware of the effects of cycloplegia on their findings.

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Predictability of myometrial, lower uterine segment and cervical invasion with 3D transvaginal ultrasonography and magnetic resonance imaging in endometrial cancer patients: a prospective cohort study

Medical Ultrasonography ◽

10.11152/mu-1493 ◽

2018 ◽

Vol 20 (3) ◽

pp. 348 ◽

Cited By ~ 2

Author(s):

Nuri Yildirim ◽

Bahadir Saatli ◽

Semir Kose ◽

Ceren Sancar ◽

Cagnur Ulukus ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Endometrial Cancer ◽

Magnetic Resonance ◽

Cancer Patients ◽

Imaging Techniques ◽

Three Dimensional ◽

Lower Uterine Segment ◽

Transvaginal Ultrasonography ◽

Resonance Imaging ◽

Sensitivity Specificity

Aims: The objective of this study is to identify the diagnostic performance of three-dimensional transvaginal ultrasonography (3D-US) and magnetic resonance imaging (MRI) in detecting myometrial, lower uterine segment and/or cervical invasion in endometrial cancer patients.Materials and methods: In this prospective study, 40 patients diagnosed with endometrial cancer were performed 3D-US and MRI, preoperatively. Deep myometrial, lower uterine segment and cervical invasion were evaluated subjectively and results were compared with the final histology as a gold standard.Results: Diagnostic accuracy of 3D-US for detecting deep myometrial, lower uterine segment and cervical invasion were 87.5%, 80% and 85%, respectively. The same results for MRI were 75%, 65% and 70%, respectively. For deep myometrial, lower uterine segment and/or cervical invasion in endometrial cancer, 3D-US had higher sensitivity, specificity, negative and positive predictive value and accuracy than MRI. The combination of these two imaging techniques had an increased sensitivity of detecting all parameters related with tumoral invasion but decreased specificity and the accuracy.Conclusion: 3D-US had better performance in detecting myometrial, lower uterine segment and/or cervical invasion than MRI in endometrial cancer patients. Combination of these techniques was not preferred according to this study.

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Endometrial assessment by transvaginal ultrasonography and correlation with histopathology among post menopausal women

Journal of Pathology of Nepal ◽

10.3126/jpn.v10i1.26936 ◽

2020 ◽

Vol 10 (1) ◽

pp. 1613-1617

Author(s):

Hari Kishor Shrestha ◽

Ram Chandra Adhikari ◽

Khadga Bahadur Shrestha

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Endometrial Thickness ◽

Transvaginal Ultrasonography ◽

Menopausal Women ◽

History Of ◽

Post Menopausal ◽

Sensitivity Specificity ◽

Age Range

Background: Transvaginal ultrasonography has increased the reliability of imaging diagnosis of women with endometrial pathologies and this technique has become widely used to evaluate endometrial thickness in women with postmenopausal bleeding. Materials and methods: 359 women presenting with history of at least three months amenorrhea were undergone transvaginal ultrasonography with measurement of endometrial thickness and uterine size. Endometrial biopsies were taken in 69 cases (19.2%) only. Results: The median age of patients was 53 years with the age range of 42 years to 81 years. Abdominal pain was the commonest symptoms followed by backache. 3/69 cases with histopathological diagnoses had normal sized uterus, while 66 cases had bulky (>6.0 cm) uterus. 58/69 cases showed > 5 mm thick endometrium and the endometrium was abnormal in 31/69 cases. The sensitivity, specificity, positive predictive value and negative predictive value of transvaginal ultrasonography to detect abnormal endometrium were 91.2%, 22.9%, 53.4% and 72.7% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of transvaginal ultrasonography to detect endometrial hyperplasia and carcinoma were 100%, 17.5%, 10.3% and 100% respectively. Conclusions: Transvaginal sonographic evaluation of endometrial thickness and uterine size is useful for exclusion of endometrial pathology and to avoid unnecessary invasive surgical procedures.

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The value of S-Detect in improving the diagnostic performance of radiologists for the differential diagnosis of thyroid nodules

Medical Ultrasonography ◽

10.11152/mu-2501 ◽

2020 ◽

Vol 22 (4) ◽

pp. 415

Author(s):

Qi Wei ◽

Shu-E Zeng ◽

Li-Ping Wang ◽

Yu-Jing Yan ◽

Ting Wang ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Predictive Value ◽

Diagnostic Performance ◽

Thyroid Nodules ◽

Characteristic Curve ◽

Diagnostic Value ◽

Ultrasound Images ◽

Experienced Radiologist ◽

Before And After ◽

Sensitivity Specificity

Aims: To compare the diagnostic value of S-Detect (a computer aided diagnosis system using deep learning) in differentiating thyroid nodules in radiologists with different experience and to assess if S-Detect can improve the diagnostic performance of radiologists.Materials and methods: Between February 2018 and October 2019, 204 thyroid nodules in 181 patients were included. An experienced radiologist performed ultrasound for thyroid nodules and obtained the result of S-Detect. Four radiologists with different experience on thyroid ultrasound (Radiologist 1, 2, 3, 4 with 1, 4, 9, 20 years, respectively) analyzed the conventional ultrasound images of each thyroid nodule and made a diagnosis of “benign” or “malignant” based on the TI-RADS category. After referring to S-Detect results, they re-evaluated the diagnoses. The diagnostic performance of radiologists was analyzed before and after referring to the results of S-Detect.Results: The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of S-Detect were 77.0, 91.3, 65.2, 68.3 and 90.1%, respectively. In comparison with the less experienced radiologists (radiologist 1 and 2), S-Detect had a higher area under receiver operating characteristic curve (AUC), accuracy and specificity (p <0.05). In comparison with the most experienced radiologist, the diagnostic accuracy and AUC were lower (p<0.05). In the less experienced radiologists, the diagnostic accuracy, specificity and AUC were significantly improved when combined with S-Detect (p<0.05), but not for experienced radiologists (radiologist 3 and 4) (p>0.05).Conclusions: S-Detect may become an additional diagnostic method for the diagnosis of thyroid nodules and improve the diagnostic performance of less experienced radiologists.

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Changes of miR-130a and ET-1 and Their Predictive Value for In-Stent Restenosis after Percutaneous Coronary Intervention

Iranian Journal of Public Health ◽

10.18502/ijph.v49i3.3142 ◽

2020 ◽

Author(s):

Hongliang LIU ◽

Hao QIAN ◽

Junlin MA ◽

Qiming DAI ◽

Mingyue JI

Keyword(s):

Risk Factors ◽

Percutaneous Coronary Intervention ◽

Predictive Value ◽

Roc Curves ◽

Coronary Intervention ◽

Stent Restenosis ◽

Percutaneous Coronary ◽

Before And After ◽

Independent Risk Factors ◽

Sensitivity Specificity

Background: To explore the changes of miR-130a and endothelin -1 (ET-1) and their predictive value for instent restenosis (ISR) after percutaneous coronary intervention (PCI). Methods: Overall, 253 patients with coronary heart disease (CHD) treated with PCI in Lianshui County People's Hospital, Huaian, China from April 2013 to May 2016 were selected. The changes of miR-130a and ET-1 levels before and after PCI were compared. The predictive value of miR-130a and ET-1 for ISR was analyzed by receiver operating characteristic (ROC) curves, and the correlation between ISR and miR-130a, ET-1 was analyzed by Kaplan-Meier (K-M) curve. The risk factors of ISR in CHD patients were evaluated by logistics regression analysis. Results: The postoperative levels of miR-130a and ET-1 were significantly increased (P<0.05). The levels of miR-130a and ET-1 in peripheral blood of patients with ISR were higher than those in patients without ISR (P<0.05). The ROC curves showed that the area under curve (AUC), sensitivity, specificity and critical value of miR-130a in predicting ISR were respectively 0.912, 92.02%, 73.47%, 1.457 pmol/L, and those of ET-1 were 0.814, 87.63%, 63.27%, 2.245 pmol/L, respectively. The K-M curve showed that the incidence of ISR in patients with high expression of miR-130a or ET-1 was significantly higher than that in patients with low expression (P<0.05). miR-130a and ET-1 were independent risk factors for ISR (P<0.05). Conclusion: MiR-130a and ET-1 have high predictive value for ISR after PCI and are independent risk factors for CHD patients, which are worthy of clinical application.

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Comparison of diagnostic accuracy of hysteroscopy and ultrasonography in relation to histopathology in cases of postmenopausal bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205236 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4995

Author(s):

Dilpreet K. Pandher ◽

Alka Sehgal ◽

Ranjeev Bhagat ◽

Poonam Goel

Keyword(s):

Predictive Value ◽

Relevant Information ◽

Morbidity Rate ◽

Recurrent Bleeding ◽

Contraceptive Device ◽

Postmenopausal Bleeding ◽

Endometrial Polyps ◽

Predictive Values ◽

One Year ◽

Sensitivity Specificity

Background: To evaluate the role of hysteroscopy and ultrasound in relation to histological findings in patients of postmenopausal bleeding and to find out the sensitivity, specificity, positive predictive, negative predictive values and accuracy of ultrasound and hysteroscopy.Methods: A retrospective analysis of the 30 women who underwent hysteroscopic evaluation out of total 103 patients of postmenopausal bleeding over the period of one year (August 2017 and July 2018) was done. Records were taken out to collect the relevant information. USG and hysteroscopic findings were correlated with histopathology for the comparative analysis.Results: Indications of hysteroscopy cases were suspected polyp (5), fractional curettage (F/C) technically not feasible (7), inconclusive USG reports (5), recurrent bleeding with normal fractional curettage report (4), no tissue on F/C (1), removal of intra-uterine contraceptive device (1). Causes of postmenopausal uterine bleeding were found to be atrophic endometrium including one case of senile cystic atrophy (33.3%), secretory endometrium and endometrial polyps (23.3% each) and endometrial malignancy (20.0%) cases. Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy values of USG in various endometrial conditions was found to be 57.1%, 85.2%, 55.1%, 86.2% and 78.5% respectively and for hysteroscopy was 87.1%, 97.5%, 90.0%, 96.7% and 95.3% respectively.Conclusions: Hysteroscopy is a minimally invasive, safe and effective modality with least complications and morbidity rate and an ideal method for establishing the pathology as well as offering therapeutic intervention simultaneously.

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Sensitivity and specificity of the treatment methods included in the standards of health resort treatment

Kazan medical journal ◽

10.17750/kmj2015-593 ◽

2015 ◽

Vol 96 (4) ◽

pp. 593-597

Author(s):

A R Agasiyev

Keyword(s):

Sensitivity And Specificity ◽

Predictive Value ◽

Liver Diseases ◽

Therapeutic Effects ◽

Health Resort ◽

Treatment Methods ◽

Choice Of Treatment ◽

The Russian Federation ◽

Majority Groups ◽

Sensitivity Specificity

Aim. To estimate the sensitivity and specificity of the treatment methods of health resort treatment according to standards of the Russian Federation. Methods. A fourfold table was created using the data of standards and sensitivity, specificity and predictive value parameters of health resort treatments were determined. 10 groups of diseases: arterial hypertension, ischemic heart disease, cerebrovascular disease, autonomic disorders, polyneuropathy, radiculopathy and plexopathy, urolithiasis, glomerular disease, liver diseases, gallbladder diseases, diseases of biliary tract and pancreas, diabetes mellitus, joint diseases. Comparison of therapeutic effects of recommended methods for the diseases was performed. The comparison was performed by the fourfold table scheme. Results. Treatment methods were allocated to the following groups: (1) methods used in all patients irrespective of the main disease; (2) methods used at the majority groups of diseases with different frequency; (3) methods which were selectively administered in certain groups of diseases. It was shown that the existing treatment methods in a set of standards differ by sensitivity, specificity and predictive value, which is associated with insufficient differentiation of indications for their use. Conclusion. While providing the health resort treatment, a choice of treatment methods by a doctor in charge considering the main and concomitant conditions plays the major role.

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The Predictive Value of Endometrial Thickness in Endometrial Pathologies in Premenopausal Women with Abnormal Uterine Bleeding

Galen Medical Journal ◽

10.31661/gmj.v2i4.111 ◽

2013 ◽

Vol 2 (4) ◽

pp. 141-145

Author(s):

Roksana Darabi ◽

Mitra Mohit ◽

Hengameh Mohammadkhani ◽

Fathemeh Mohammadyari ◽

Soheila Yadollah-Damavandi

Keyword(s):

Predictive Value ◽

Endometrial Thickness ◽

Premenopausal Women ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Endometrial Polyps ◽

Low Area ◽

Area Under Roc Curve ◽

Sensitivity Specificity

AbstractBackground: Abnormal uterine bleeding (AUB) is one of the most common complains in women of any age seeking gynecologic health care and needs early diagnosis and proper management due to its impacts on the quality of life. This study was conducted to investigate the cut-off value of endometrial thickness (ET) by trans-vaginal ultra-sonography (TVUS) and evaluate its accuracy in the diagnosis of the endometrial abnormalities in premenopausal women with AUB.Materials and Methods: In this descriptive study, 64 married women between 35-50 years old were evaluated due to AUB during 2011-2012; TVUS and fractional curettage were done. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the ET were calculated in different cut-off values.Results: The pathological evaluations of the biopsies were normal in 37 (57.8%) patients and were abnormal in 27 (42.2%) patients, 19 endometrial polyps, 6 hyperplastic lesions and 2 endometrial cancers. ET=4 mm had 100% sensitivity, 100% NPV, 10% specificity and 28% PPV in the detection of endometrial abnormalities. ET<10 mm had a proper sensitivity (67%-100%) and NPV (78.6%-100%) but specificity was low (%10-%44). ET=10 mm with sensitivity=63%, specificity=60%, NPV=65.8% and PPV=48.2% was introduced as the cut-off point with the best area under curve (LR+=2.22 LR- =0.77).Conclusion: Although an ET<10 mm was less likely to be associated with an endometrial abnormality, the low PPV of ET and low area under ROC curve shows sonography has high false positivity in premenopausal women. ET≤4 mm was more reliable and could reduce unnecessary biopsies.

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Evaluation of endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal women with abnormal uterine bleeding at tertiary rural centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200368 ◽

2020 ◽

Vol 9 (2) ◽

pp. 735

Author(s):

Priyanka Singh ◽

Kalpana Kumari ◽

Shikha Seth ◽

Vandana Verma ◽

Vikram Singh

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Ultrasonography ◽

Age Group ◽

Guided Biopsy ◽

Perimenopausal Women ◽

Sensitivity Specificity

Background: Abnormal uterine bleeding is one of the commonest clinical presentation ac-counts for 33% gynaecological consultations and this proportion rises to 70% in perimenopausal and postmenopausal age group in any gynaecology clinic. The most probable etiology of abnormal uterine bleeding relates to the patients reproductive age. Various diagnostic techniques have been evolved over the periods to determine the etiology of abnormal uterine bleeding in perimenopausal women, but their accuracy has not been compared properly. The aim of study is to evaluate the endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal patients with abnormal uterine bleeding.Methods: Total 96 patients in perimenopausal age group, admitted with chief complaints of ab-normal uterine bleeding were included. All patients underwent transvaginal ultrasonography and hysteroscopy, followed by hysteroscopy guided biopsy and histopathological examination. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated for both methods and compared, considering histopathological diagnosis as gold standard.Results: Mean age of patients was 44.05±3.29. Hysteroscopy has high accuracy, sensitivity, specificity, positive predictive value and negative predictive value than Transvaginal sonography for diagnosis of all endometrial and intrauterine pathologies.Conclusions: Hysteroscopy results are more consistent with the results of histopathology. Hysteroscopy and hysteroscopy guided biopsy has been proven as gold standard for endometrial evaluation of patients with abnormal uterine bleeding. TVS can be used as most cost effective first step investigation in cases of perimenopausal bleeding.

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