Sonographic and Hysteroscopic Assessment of Uterine Congenital Malformations: A Retrospective Study

Aim: Congenital uterine malformations are often diagnosed via Transvaginal Sonography (TVS) and/or office hysteroscopy. Few studies address the diagnostic accuracy of both techniques in detecting these abnormalities. The aim of this study is to evaluate sonographic and hysteroscopic findings in women with uterine congenital malformations. Methods and Materials: A nested retrospective study on 137 medical records of women with congenital malformations undergoing vaginoscopic office hysteroscopic and transvaginal sonographic assessment in the Endoscopic Unit, Department of Gynaecology, University Hospital of Ioannina, Greece was conducted. All women were examined initially via Transvaginal Sonography (TVS) and the sonographic findings were correlated with the hysteroscopic findings. Women with septate or bicornuate uteri confirmed their pathology through laparoscopy, a proposed gold standard technique. Result: Hysteroscopy was able to detect 136 out of 137 cases of congenital malformations with a false positive bicornuate uterus. Transvaginal sonography (TVS) showed moderate diagnostic accuracy accompanied by positive predictive value (PPV) at 79.79%, negative predictive value (NPV) at 99.17%, sensitivity at 79.79%, and finally specificity at 99.17%. Endometrial thickness assessed by TVS was found to be higher in cases of complete septate and bicornuate uteri. The incidence of congenital malformation within the total population was estimated at 4.56%. Conclusion: Diagnostic hysteroscopy is a reliable tool in detection uterine congenital malformations compared to two-dimensional sonography. Office hysteroscopy demonstrates high diagnostic accuracy and should replace traditional sonographic assessment in determining congenital uterine malformations. Clinical significance: Hysteroscopy is superior than TVS in detecting uterine congenital malformations.

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Evaluation of endometrial causes of postmenopausal bleeding with it's correlation with endometrial thickness and hysteroscopy findings and endometrial tissue histopathology

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202737 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2940

Author(s):

Saurabh V. Bhangale ◽

Shailja Sharma ◽

Asmita Patil ◽

Beena Kumari

Keyword(s):

Diagnostic Accuracy ◽

Endometrial Carcinoma ◽

Predictive Value ◽

Histopathological Examination ◽

Endometrial Thickness ◽

Endometrial Tissue ◽

Transvaginal Sonography ◽

Histopathological Diagnosis ◽

Postmenopausal Bleeding ◽

Dilation And Curettage

Background: Postmenopausal bleeding (PMB)accounts for 5% of gynecology visit. All with unexpected uterine bleeding should be evaluated for endometrial carcinoma since this potentially lethal disease is the cause of bleeding in approximately 10 percent patients (range 1 to 25 percent, depending upon risk factors). The aim of the study was to evaluate endometrial causes of postmenopausal bleeding (PMB) with it's correlation with endometrial thickness (ET)and hysteroscopy findings and endometrial tissue histopathology.Methods: A total 50 consecutive cases of PMB fulfilling the inclusion and exclusion criteria and giving informed consent were selected. Each patient was subjected to transvaginal sonography (TVS) in which uterus, adnexa and endometrial thickness (ET) was assessed. Then hysteroscopy and/or dilation and curettage was scheduled at subsequent visit. Endometrial sample was sent for histopathological examination. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy was calculated for ET by TVS and hysteroscopy findings, considering histopathological diagnosis as the gold standard.Results: Most common endometrial cause of PMB was atrophic endometrium (44%). The other causes were endometrial carcinoma (18%), endometrial hyperplasia (18%), endometrial polyp (12%), endometritis (4%), and leiomyoma (4%). The diagnostic accuracy of ET by TVS at a cut-off point of 5 mm was 94% with sensitivity 89.3%, specificity 100%, PPV 100% and NPV 88%. The diagnostic accuracy of hysteroscopy was 98% with sensitivity 96.4%, specificity 100%, PPV 100% and NPV 95.7%.Conclusions: Being relatively cheap, easily accessible, non-invasive, TVS with ET measurement should first line investigation in the evaluation of women with postmenopausal bleeding with suspected endometrial pathology. Although hysteroscopy is more specific and sensitive, in poor resource settings it should be limited to cases with ill-deﬁned endometrial lining, recurrent/ persistent bleeding and cases with endometrial thickness greater than 5 mm irrespective of endometrial echotexture.

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Diagnostic Accuracy of Transvaginal Sonography in the Detection of Endometrial Polyps

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479319879374 ◽

2019 ◽

Vol 36 (1) ◽

pp. 31-35

Author(s):

Yevheniia Poliakova ◽

Nataliia Lutsenko

Keyword(s):

Retrospective Study ◽

Diagnostic Accuracy ◽

Predictive Value ◽

False Negative ◽

Transvaginal Sonography ◽

Endometrial Polyps ◽

Sonographic Diagnosis ◽

Dilation And Curettage ◽

Uterine Anomalies ◽

Sensitivity Specificity

Background: Transvaginal sonography (TVS) is considered a simple and generally accepted method for detecting uterine anomalies. With TVS, the uterus can be clearly visualized, but so far, the diagnostic accuracy of TVS varies across different studies. This retrospective study was devised to evaluate the accuracy of a sonographic diagnosis of endometrial polyps in a Ukrainian hospital. Methods: This was a single-center retrospective study of woman who underwent TVS and had hysteroscopy or dilation and curettage for endometrial pathology. A cohort of 156 women were included in this yearlong study. A comparative analysis was based on the preoperative diagnosis, according to TVS, compared with the postoperative histopathology results. Results: The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of TVS in diagnosing endometrial polyps were 69%, 51%, 73%, 46%, and 63%, respectively. Conclusion: This retrospective study provided data on the lack of accuracy for a sonographic diagnosis of endometrial polyps. This was based on 26% of women whose diagnosis was not confirmed by histology. A false-negative result occurred for 54% of women who had polyps that were not detected at the preoperative stage. These data raise the question of the feasibility of further invasive procedures based on a single TVS study.

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Accuracy of Electronic Surveillance of Catheter-Associated Urinary Tract Infection at an Academic Medical Center

Infection Control and Hospital Epidemiology ◽

10.1086/529079 ◽

2014 ◽

Vol 35 (06) ◽

pp. 685-691 ◽

Cited By ~ 7

Author(s):

H. L. Wald ◽

B. Bandle ◽

A. Richard ◽

S. Min

Keyword(s):

Urinary Tract ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Medical Center ◽

Academic Medical Center ◽

University Hospital ◽

Reference Standard ◽

Electronic Surveillance ◽

Tract Infections ◽

Sensitivity Specificity

Objective.To develop and validate a methodology for electronic surveillance of catheter-associated urinary tract infections (CAUTIs).Design.Diagnostic accuracy study.Setting.A 425-bed university hospital.Subjects.A total of 1,695 unique inpatient encounters from November 2009 through November 2010 with a high clinical suspicion of CAUTI.Methods.An algorithm was developed to identify incident CAUTIs from electronic health records (EHRs) on the basis of the Centers for Disease Control and Prevention (CDC) surveillance definition. CAUTIs identified by electronic surveillance were compared with the reference standard of manual surveillance by infection preventionists. To determine diagnostic accuracy, we created 2 × 2 tables, one unadjusted and one adjusted for misclassification using chart review and case adjudication. Unadjusted and adjusted test statistics (percent agreement, sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], and κ) were calculated.Results.Electronic surveillance identified 64 CAUTIs compared with manual surveillance, which identified 19 CAUTIs for 97% agreement, 79% sensitivity, 97% sensitivity, 23% PPV, 100% NPV, and κ of .33. Compared with the reference standard adjusted for misclassification, which identified 55 CAUTIs, electronic surveillance had 98% agreement, 80% sensitivity, 99% specificity, 69% PPV, 99% NPV, and κ of .71.Conclusion.The electronic surveillance methodology had a high NPV and a low PPV compared with the reference standard, indicating a role of the electronic algorithm in screening data sets to exclude cases. However, the PPV markedly improved compared with the reference standard adjusted for misclassification, suggesting a future role in surveillance with improvements in EHRs.Infect Control Hosp Epidemiol2014;35(6):685–691

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VP63.17: A retrospective study on the diagnostic accuracy of transvaginal sonography of adenomyosis in a single tertiary hospital

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.23421 ◽

2020 ◽

Vol 56 (S1) ◽

pp. 353-353

Author(s):

A. Zamora ◽

C. Cabitac‐Samonte

Keyword(s):

Retrospective Study ◽

Diagnostic Accuracy ◽

Tertiary Hospital ◽

Transvaginal Sonography

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Comparative retrospective study on transvaginal sonography versus office hysteroscopy in the diagnosis of endometrial pathology among different subgroups

Journal of Obstetrics and Gynaecology Research ◽

10.1111/jog.14580 ◽

2020 ◽

Author(s):

Orestis Tsonis ◽

Fani Gkrozou ◽

Evangelos Dimitriou ◽

Minas Paschopoulos

Keyword(s):

Retrospective Study ◽

Transvaginal Sonography ◽

Office Hysteroscopy ◽

Endometrial Pathology

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Usefulness of Grey Scale and Doppler transvaginal sonography in diagnosis of ovarian torsion

Journal of Fatima Jinnah Medical University ◽

10.37018/kori7947 ◽

2020 ◽

Vol 14 (2) ◽

pp. 97-102

Author(s):

Khalid Rehman `Yousaf ◽

Shahzad Saeed ◽

Saman Chaudhry ◽

Rabia Bashrat ◽

Abadullah Khalid ◽

...

Keyword(s):

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Ovarian Function ◽

Imaging Modality ◽

Ovarian Torsion ◽

Transvaginal Sonography ◽

Predictive Values ◽

Grey Scale ◽

Sensitivity Specificity

Background: Ovarian torsion diagnosis is a great challenge as delay in diagnosis can cause severe morbidity. Early accurate diagnosis is crucial to preserve ovarian function. Ultrasonography being the primary imaging modality plays a vital role in the evaluation of suspected ovarian torsion by helping surgeons reach the correct diagnosis, thus avoiding unnecessary intervention. This study aims to determine the diagnostic accuracy of isolated and combined sonographic features of ovarian torsion on grey scale and Doppler transvaginal ultrasonography. Patients and methods: From radiology database, from January 2016 till December 2019, sonographic signs of ovarian torsion in 113 women with suspected ovarian torsion on ultrasonography and subsequent surgical diagnosis were evaluated. Ultrasound findings were compared with surgical findings to determine the accuracy, sensitivity, specificity, and positive and negative predictive values of individual and combined ultrasound signs. Results: Diagnostic accuracy of ultrasound for ovarian torsion was 85.8%. Abnormal ovarian Doppler flow was the most accurate individual sonographic sign with accuracy, sensitivity, specificity and positive predictive value of 85.8%, 83.5%, 100% and 100% respectively followed by ovarian enlargement and ovarian edema. Combined ultrasound signs resulted in higher sensitivity and positive predictive values, and lower specificity and negative predictive values for ovarian torsion. Increasing the number of sonographic parameters increased the specificity but decreased sensitivity. High accuracy, sensitivity, positive predictive value, specificity and negative predictive value was seen when combination of three or two sonographic parameters was used as diagnostic criteria. Conclusion: Transvaginal sonography is a convenient, reliable and extremely useful imaging modality for preoperative diagnosis of ovarian torsion with high specificity, sensitivity, positive predictive value and diagnostic accuracy helping treating physicians to take prompt decisions regarding timely surgical intervention. However, due to low negative predictive values, absence of sonographic signs does not rule out ovarian torsion and high index of clinical suspicion remains of utmost importance.

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Diagnostic accuracy of frozen section in detecting malignant brain tumors taking histopathology as gold standard.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.09.3835 ◽

2020 ◽

Vol 27 (09) ◽

pp. 1814-1817

Author(s):

Saad Akhter Khan ◽

Badar Uddin Ujjan ◽

Naveed Zaman Akhunzada ◽

Saad Bin Anis

Keyword(s):

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Negative Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

Frozen Section ◽

Malignant Gliomas ◽

University Hospital ◽

Neoplastic Tissue ◽

Tissue Water

Objectives: To evaluate the diagnostic accuracy of frozen section in detecting malignant gliomas, taking histopathology as gold standard. Study Design: Cross-Sectional study. Setting: Neurosurgery Department, Aga Khan University Hospital, Karachi. Period: From March 2018 to Jan 2019. Material & Methods: Through consecutive sampling technique, total 100 specimens from patients suspected of malignant gliomas on MRI brain with contrast, who were admitted in the neurosurgery department for elective tumor surgery were included. Intraoperatively, the specimen from the lesion identified on imaging through neuro-navigation was taken and sent to histopathology department for frozen section analysis. The histopathology consultant was pre-informed about the case and probable time of receiving the specimen. The specimen for frozen section was sent in a dried container without formalin. Once received in pathology department, the tissue is rapidly cooled through a cryostat which converts tissue water into the ice and makes the tissue rigid for cutting into slices and viewing under the microscope for identifying the neoplastic tissue. The consultant histopathologist was request to provide frozen section report immediately and to keep the remaining specimen for definitive histopathology reporting as well. Data of malignancy on both Frozen Section and formal histopathology report was noted and comparison was done. Results: Mean age of the patients was 36.7±8.76 years. There were 64 (64%) male patients and 36 (36%) female patients. Diagnostic accuracy of frozen section taking histopathology as a gold standard shows that sensitivity was found to be 83.3%, specificity 84.4%, Positive predictive value (PPV) 71.4% and negative predictive value (NPV) 91.5% & Overall diagnosis accuracy was found 96.6%. Conclusion: The Diagnostic accuracy of frozen section (FS) in detection of brain malignant gliomas was found to be satisfactory. It has a diagnostic accuracy of 96.9%, sensitivity 83.3%, specificity 84.4%, Positive predictive value (PPV) 71.4% and negative predictive value (NPV) 91.5%.

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Liquid-based endometrial cytology: its possible value in postmenopausal asymptomatic women

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2006.00757.x ◽

2007 ◽

Vol 17 (1) ◽

pp. 182-187 ◽

Cited By ~ 22

Author(s):

A. M. Buccoliero ◽

F. Castiglione ◽

C. F. Gheri ◽

F. Garbini ◽

M. Fambrini ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Postmenopausal Women ◽

Negative Predictive Value ◽

Predictive Value ◽

False Positive ◽

Endometrial Adenocarcinoma ◽

Atypical Hyperplasia ◽

Transvaginal Sonography ◽

Endometrial Cytology ◽

Asymptomatic Women

The incidence of endometrial adenocarcinoma in asymptomatic women is low. Nevertheless, some of these women might require endometrial surveillance. In this study, we evaluated the accuracy of liquid-based endometrial cytology compared to biopsy in asymptomatic postmenopausal women. Three hundred twenty women scheduled for hysteroscopy were enrolled for this study. After hysteroscopy, patients were submitted to endometrial cytology and to biopsy. Two hundred ninety-three (92%) women had sonographically thickened endometrium (>5 mm), 53 (17%) were on tamoxifen, and 16 (5%) were on hormonal substitutive treatment. The evaluation of the biopsies determined that six (2%) women had adenocarcinoma, one (<1%) had adenomatous atypical hyperplasia, and eight (3%) had simple nonatypical hyperplasia. Endometrial cytology evidenced 5 (2%) neoplastic cases, 2 (<1%) hyperplastic with atypia cases, and 25 (8%) hyperplastic without atypia cases. Two hundred twenty-two biopsies (69%) and 17 (5%) cytologies were inadequate. One adenocarcinoma and one simple nonatypical hyperplasia were underrated by cytology resulting, respectively, as atypical hyperplasia and as negative. Four cases were false positive (simple nonatypical hyperplasias on cytology, negative on biopsy). The sensitivity and specificity were estimated, respectively, at 94% and 95%; the positive and negative predictive value were estimated, respectively, at 80% and 99%. Endometrial cytology provided sufficient material more often than biopsy (P < 0.01). We suggest to introduce liquid-based endometrial cytology in the management of some subpopulations of asymptomatic postmenopausal women. Particularly, the combination of liquid-based endometrial cytology and transvaginal sonography may improve their diagnostic accuracy and reduce unnecessary more invasive and expensive procedures.

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Accuracy of Electronic Surveillance of Catheter-Associated Urinary Tract Infection at an Academic Medical Center

Infection Control and Hospital Epidemiology ◽

10.1086/676429 ◽

2014 ◽

Vol 35 (6) ◽

pp. 685-691 ◽

Cited By ~ 3

Author(s):

H. L. Wald ◽

B. Bandle ◽

A. Richard ◽

S. Min

Keyword(s):

Urinary Tract ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Medical Center ◽

Academic Medical Center ◽

University Hospital ◽

Reference Standard ◽

Electronic Surveillance ◽

Tract Infections ◽

Sensitivity Specificity

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Uterine and tubal anatomical abnormalities in infertile women: diagnosis with routine hysterosalpingography prior to selective laparoscopy

South African Journal of Radiology ◽

10.4102/sajr.v15i4.354 ◽

2011 ◽

Vol 15 (4) ◽

pp. 120 ◽

Cited By ~ 3

Author(s):

Mwaffaq Heis ◽

Zouhair Amarin ◽

Alaa Ibrahim ◽

Nael Obeidat ◽

Basil Obeidat ◽

...

Keyword(s):

Retrospective Study ◽

Predictive Value ◽

University Hospital ◽

Tubal Occlusion ◽

Infertile Women ◽

The North ◽

Procedural Complications ◽

The Mean ◽

Bilateral Salpingectomy ◽

Very High

Objective: To assess the findings and usefulness of hysterosalpingography as a routine investigation in the fertility workup prior to selective laparoscopy. Design: Descriptive retrospective study. Setting: A university hospital in the north of Jordan. Subjects: All hysterosalpingographies performed in the period between 1st January and 31 December 2008. Outcome measures: Detection of uterine and fallopian tube abnormalities and their correlation with laparoscopic findings. Results: During the study period, 281 infertile women underwent hysterosalpingography with no post procedural complications. The mean (SD) age was 31.5 (5.91) years. Mean (SD) duration of infertility was 4 (3.44) years. Infertility was reported as primary and secondary by 119 (42.3 %) and 162 (57.6 %), respectively. Altogether 281 patients and 562 tubes were examined. Of those, 402 were patent and 160 occluded. There was only one woman in whom peritubal adhesions were diagnosed. Because of hysterosalpingographically diagnosed tubal occlusion, 46 women (16.4 %) were referred for laparoscopy. Eight (17.3%) of them were treated with unilateral salpingectomy and 28 (60.8%) with bilateral salpingectomy. Salpingolysis was performed for 7 (15.2%) women, and 3 (6.7%) women had untreatable adhesions. The concordance was 71.7%. The sensitivity of HSG was 80%, the specificity 50%, the negative predictive value 61% and the positive predictive value 71%. Of the total of 281 women, 30 (10.7%) conceived within 1 - 11 months after the hysterosalpingography. Conclusions: The very high abnormal predictive value of hysterosalpingography in the diagnosis of tubal occlusion suggests that this procedure could be performed as a screening examination.

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