scholarly journals Hysterosonography and Transvaginal Ultrasonography for Detection of Intrauterine Lesions in Women with Abnormal Uterine Bleeding

2017 ◽  
Vol 23 (1) ◽  
Author(s):  
Iqbal Hussain Dogar ◽  
Mahjabeen Masood ◽  
Mahesh Gautam ◽  
Mahjabeen Tariq
Keyword(s):  
Sensitivity And Specificity ◽  
Imaging Modality ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Vital Role ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Transvaginal Ultrasonography ◽  
Detection And Identification ◽  
Line Imaging

<p>Abnormal Uterine bleeding (AUB) is one of the frequent complaints of female patients of all ages. AUB is present in 33% of women referred to gynecologists and this increases to 69% in perimenopausal and postmenopausal women. About 10 % of postmenopausal bleeding results from endometrial cancer and imaging is the mainstay for its identification. Imaging plays a vital role in differentiating structural lesions like endometrial carcinomas, myomas and polyps which require surgical management from functional disorders requiring medical management. Transvaginal Ultrasonography (TVUS) is the first line imaging modality for AUB after selecting the patients with inconclusive pelvic ultrasonographic results. Hysterosonography (HSG) also plays a pivotal role.</p><p><strong>Objectives</strong><strong>:</strong>  To compares between TVUS and HSG in the detection and identification of intrauterine lesions in patients with abnormal uterine bleeding, and comparing the sensitivity and specificity of the respective methods in the detection of such lesions.</p><p><strong>Methods: </strong> Thisstudy was conducted in Department of Radiology, Mayo Hospital Lahore. Fifty women presented with history of abnormal uterine bleeding were included in this study. Pregnancy was ruled out by transabdominal scan. Transvaginal ultrasound and hysterosonography were performed in all the patients. All the data were coded and analyzed using SPSS version 20.</p><p><strong>Results:  </strong>Out of 50 patients, 10 patients had intramyometrial fibroid, 11 had submucosal fibroid, endometrial polyp was found in 17 patients and 2 patients had thickened endometrium (thickness &gt; 8mm). The sensitivity and specificity of TVUS was found to be 83.2% and 82.7% respectively whereas HSG showed sensitivity and specificity of 95.4% and 91.5% respectively. In the detection of the submucosal fibroid and endometrial polyp, HSG showed highest sensitivity and specificity as compared totransvaginal ultrasound.</p><p><strong>Conclusion:  </strong>Both the TVUS and HSG have comparable sensitivity and specificity in the detection of endometrial disease in patients presented with abnormal uterine bleeding however HSG is more sensitive in the detection of polyps.</p>

scholarly journals Transvaginal Ultrasonography and Saline Infusion Sonohysterography for the Detection of Intra-Uterine Lesions in Pre- and Post-Menopausal Women with Abnormal Uterine Bleeding

2008 ◽  
Vol 36 (6) ◽  
pp. 1205-1213 ◽  
Author(s):  
B Yildizhan ◽  
R Yildizhan ◽  
B Ozkesici ◽  
N Suer
Keyword(s):  
Sensitivity And Specificity ◽  
Uterine Fibroids ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Saline Infusion ◽  
Transvaginal Ultrasonography ◽  
Endometrial Polyps ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Saline Infusion Sonohysterography

This prospective study investigated 79 pre- and 25 post-menopausal women with abnormal uterine bleeding who underwent conventional transvaginal ultrasonography (TVS) and saline infusion sonohysterography (SIS) and compared the results with histopathological findings obtained by dilatation and curettage, hysteroscopy or hysterectomy. Histological examination revealed normal endometrial histology in 28 patients, intracavitary polyps in 46 patients, submucosal fibroids in 18 patients, intramural fibroids in six patients and endometrial hyperplasia in six patients. The sensitivity and specificity of TVS in detecting endometrial polyps were 65.2% and 87.9%, respectively, compared with 91.3% and 93.1% for SIS. The sensitivity and specificity of TVS in detecting uterine fibroids were 95.8% and 95.0%, respectively, versus 91.6% and 98.7% for SIS. These results show that SIS is a satisfactory method of identifying lesions and that it is easy and cost-effective, and improves on the diagnostic utility of TVS. SIS is also a less invasive alternative to hysteroscopy, so should result in less morbidity in the evaluation of abnormal uterine bleeding in women.

scholarly journals Transvaginal ultrasonography versus hysteroscopy in endometrial pathology diagnosis among women with abnormal uterine bleeding

2021 ◽  
Vol 4 (3) ◽  
pp. e24
Author(s):  
Rupalakshmi Vijayan ◽  
◽  
Rajalakshmi Kamath ◽  
Krunal Pandav ◽  
Meghana Mehendale ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Endometrial Thickness ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Ultrasonography ◽  
Inclusion Criteria ◽  
Dilatation And Curettage ◽  
Diagnostic Modalities ◽  
Rule Out

Objective: Abnormal uterine bleeding is any deviation from a normal menstrual pattern. Transvaginal ultrasonography is useful in determining endometrial thickness but cannot conclusively exclude sessile and pedunculated lesions. Hysteroscopy is an invasive procedure that detects discrete lesions. This study was aimed to evaluate the diagnostic accuracy of 2-dimensional transvaginal ultrasonography and hysteroscopy in evaluating endometrial lesions in women with abnormal uterine bleeding, by determining the sensitivity and specificity of the two methods in diagnosing the lesions. Methods: Eighty-four cases of abnormal uterine bleeding were chosen based on inclusion criteria. The patients were subjected to routine investigations. The findings of transvaginal ultrasonography, hysteroscopy, and dilatation and curettage were compared and analyzed. Results: Maximum incidence of abnormal uterine bleeding was observed in women between 41 and 50 years of age (73.8%). The most common presenting complaint was menorrhagia (76.1%). 76% of patients experienced symptoms for less than six months. The sensitivity and specificity of transvaginal ultrasonography were 60% and 96.3%, respectively. The sensitivity and specificity of hysteroscopy were 80.4% and 93.1%, respectively. The accuracy of transvaginal ultrasonography was 60.3%, and that of hysteroscopy was 83.3%. Conclusion: Transvaginal ultrasonography and hysteroscopy can be used as first-line diagnostic modalities to rule out and find the causes of abnormal uterine bleeding, which can aid in instituting prompt and appropriate medical treatment.

scholarly journals Transvaginal ultrasonography is the diagnostic method for evaluation of abnormal uterine bleeding

2012 ◽  
Vol 1 (1) ◽  
pp. 11-13
Author(s):  
Kulsum Haq ◽  
Shabnom Ferdous Chowdhury ◽  
Maksuda Mannan ◽  
Rokshana Ivy ◽  
K Shahneela Tasnim
Keyword(s):  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Transvaginal Ultrasonography ◽  
Transvaginal Sonography ◽  
Dysfunctional Uterine Bleeding ◽  
Histopathologic Evaluation

Objective: The objective of this study is to assess the utility of transvaginal ultrasonography in patients presenting abnormal uterine bleeding Materials and methods: Between July 2000 to December 2000, 50 patients underwent transvaginal sonography (TVS) for abnormal uterine bleeding. All patients had transvaginal sonography before histopathology. On TVS, the sonographic appearance of the endometrium was classified according to the following parameters: normal or abnormal thickness, homogeneous or heterogeneous echogenicity, bulbous contour, discontinuous, or obscured. A comparison was performed between TVS with histopathology. Results: The most common causes for the abnormal uterine bleeding were leiomyoma in TVS (42.0%). Other causes were dysfunctional uterine bleeding (28.0%). adenomyosis (6.0%), endometrial polyp (4.0%), thin atrophic endometrium (8.0%), endometrial hyperplasia (8.0%), and endometrial carcinoma (4.0%). After histopathologic evaluation 40.0% patients had leiomyoma, 24.0% DUB, 10.0% adenomyosis, 8.0% endometrial polyp, 8.0% thin atrophic endometrium, 6.0% endometrial carcinoma and 4.0% endometrial hyperplasia. Comparing the TVS with histopathologic findings, TVS had a sensitivity of 94.3%, specificity of 80.0%. accuracy of 90.0%, PPV of 91.6% and NPV of 85.7%. Conclusion: TVS is an easy, safe, rapid and tolerable procedure. It has an excellent diagnostic accuracy in the diagnosis of uterine pathology responsible for abnormal uterine bleeding. Abbreviation: TVS transvaginal sonography; AUB abnormal uterine bleeding; DUB dysfunctional uterine bleeding, PPV positive predictive value, NPV Negative predictive value. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12168 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.11-13

scholarly journals Efficacy of ultrasonography for structural categorisation of abnormal uterine bleeding

2021 ◽  
Vol 10 (12) ◽  
pp. 4527
Author(s):  
Jyoti Rathi ◽  
Girija Wagh
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Age Group ◽  
First Line ◽  
Gynecology And Obstetrics ◽  
Line Imaging

Background: Abnormal uterine bleeding (AUB) is defined as bleeding from the uterine corpus endometrium to be precise, the bleeding is abnormal in regularity, volume, frequency, or duration. The international federation of gynecology and obstetrics (FIGO) categorized AUB based on structured medical history, laboratory tests, ultrasound, and or hysteroscopy-based techniques.The classification is based on the phrase "PALM- COEIN", (pronounced “pahm-koin”) of which "PALM" represents polyp, adenomyosis, leiomyoma, malignancy (and hyperplasia) and defines structural pathologies that can be assessed visually. Transvaginal ultrasound (TVS) is the first-line imaging test for the evaluation of abnormal uterine bleeding in both premenopausal and postmenopausal women. The purpose of this study was to estimate the diagnostic effectiveness of two-dimensional ultrasound (TAS and TVS) in assessing the structural causes of AUB and to compare the histopathological and intraoperative findings with ultrasound.Methods: It was a prospective observational study. A total of 200 women presenting with abnormal uterine bleeding between the age group of 18-55 years were included in study. All patients were subjected to routine investigations for AUB and ultrasonography (USG). Wherever appropriate the findings of USG were compared with intra-operative and histopathology findings.Results: Diagnostic accuracy of USG was 78.1% with sensitivity and specificity of 88.5% and 60%. Positive predictive value (PPV) and negative predictive value (NPV) was 79.4% and 75%. USG is a simple, safe, fast, efficient and tolerable procedure. In diagnosing structural uterine pathology responsible for abnormal uterine bleeding, it has outstanding diagnostic accuracy and should be followed in all such cases.Conclusions: We cannot be definitive in our approaches always, USG act as a wonderful modality to help us not only in identifying the structural causes but also the functional causes. However, the gold standard of identifying endometrial pathology is histopathology and it can’t be replaced by anything.

Routine Syndecan-1 Immunohistochemistry Aids in the Diagnosis of Chronic Endometritis

2004 ◽  
Vol 128 (9) ◽  
pp. 1000-1003 ◽  
Author(s):  
Ilene B. Bayer-Garner ◽  
Jennifer A. Nickell ◽  
Soheila Korourian
Keyword(s):  
Plasma Cells ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Chronic Endometritis ◽  
Underlying Malignancy ◽  
Proliferative Endometrium ◽  
Exogenous Progesterone ◽  
Secretory Endometrium

Abstract Context.—Chronic endometritis is reportedly observed in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. The diagnosis of chronic endometritis rests on the identification of the plasma cells. Their identification may be obscured by a mononuclear cell infiltrate, plasmacytoid stromal cells, abundant stromal mitoses, a pronounced predecidual reaction in late secretory endometrium, menstrual features, or secondary changes due to exogenous progesterone treatment prior to the biopsy. Syndecan-1 is a proteoglycan that is found on the cell surface of plasma cells and keratinocytes. Immunohistochemistry stains for this antibody may facilitate diagnosis of chronic endometritis. Objective.—To determine whether or not routine syndecan-1 immunohistochemistry will aid in the diagnosis of chronic endometritis. Design.—Immunohistochemistry stains for syndecan-1 were performed on 3 levels of 47 endometrial biopsies from patients with abnormal uterine bleeding. None of the patients had endometrial hyperplasia or an underlying malignancy. Clinical correlation and follow-up was attempted in 20 cases that showed evidence of plasma cells by syndecan-1 by immunohistochemistry. Results.—Plasma cells were identified in 20 cases, 7 of which were initially diagnosed as chronic endometritis. The remaining 13 positive cases were diagnosed as tubal metaplasia (1), secretory endometrium (4), proliferative endometrium (4), menstrual endometrium (1), endometrial polyp (1), secretory endometrium with endometrial polyp (1), and endometrial polyp with exogenous hormone effect (1) based on the original hematoxylin-eosin section. Conclusions.—Syndecan-1 may be a useful adjunct in the diagnosis of chronic endometritis. Approximately half of the cases of chronic endometritis responded to an antibiotic regime; thus, this diagnosis is important and may potentially obviate the need for surgical intervention.

scholarly journals Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mohamed Laban ◽  
Sherif H. Hussain ◽  
Alaa S. Hassanin ◽  
Waleed M. Khalaf ◽  
Mohamed K. Etman ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Final Analysis ◽  
Uterine Bleeding ◽  
Endometrial Polyps ◽  
Predictive Values ◽  
Endometrial Volume ◽  
Sensitivity Specificity

The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P=0.223;P=0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

scholarly journals Co-relation of endometrial thickness by transvaginal sonogram with histopathology pattern in abnormal uterine bleeding: a study from South India

2020 ◽  
Vol 9 (4) ◽  
pp. 1416
Author(s):  
Chippy Tess Mathew ◽  
Uma Maheswari ◽  
Karthikeyan Shanmugam
Keyword(s):  
Precancerous Lesions ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Sampling ◽  
Dilatation And Curettage ◽  
Number Of Patients ◽  
Fourth Decade ◽  
Proliferative Endometrium

Background: Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period (around 80 ml). Bleeding that occurs erratically or excessive menstrual bleeding is called abnormal uterine bleeding (AUB). The causes of AUB are many and varied. Initial investigations include transvaginal ultrasound and histopathologic assessment of the endometrium. Objective of this study was to evaluation of endometrial thickness with trans-vaginal ultrasound and its correlation with histopathology by dilatation and curettage in abnormal uterine bleeding. To determine the efficacy of transvaginal ultrasound in evaluating the endometrial thickness. To correlate the endometrial thickness by transvaginal ultrasound with endometrial histopathology in women with AUB.Methods: It is a retrospective observational study. All reproductive and perimenopausal age group women who underwent dilatation and curettage for abnormal uterine bleeding during the period June 2014-June 2016 was taken and analyzed and correlated with their endometrial thickness measured with Transvaginal ultrasound.Results: Around 478 patients who underwent endometrial sampling over a period of two years were analyzed. Maximum number of patients were in the fourth decade and the overweight category 36.6%. Proliferative endometrium was the most common histopathologic picture (44.76%). Detection of precancerous lesions were-5.87% and endometrial cancer was 1.05%.Conclusions: An ET of 8 mm and above gave 100% sensitivity and negative predictive value for precancerous and cancerous lesions.

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