The Value Of Transvaginal Sonohysterography In The Diagnosis Of Endometrial Polyps

Objective：To explore the value of transvaginal sonohysterography in the diagnosisof endometrial polyps.Methods：83married female patients who were suspected endometrial polyps wereenrolled in this study from Apr,2011to Apr,2013, because of abnormal uterine bleeding,infertility or habitual abortion symptoms., between the ages of26to67years old.On cleanmenstruation after1～7days,all patients were examined by transvaginal sonohystergraphyand hysteroscopy. After all examinations,all patients were drawn for pathologic.SHG wasdeveloped in recent years to establish a new inspection method based on transvaginalultrasound diagnosis of intrauterine lesions. Because of the difference of the acousticimpedance between the contrast agent and the endometrial,we can observe the endometrialpolyps and pathological changes of form and the nature of the disease when the uterinecavity was distended with the contrast agent. By the pathology as the gold standard,transvaginal ultrasonography (TVS)、 transvaginal sonohystergraphy(SHG) andhysteroscopy（HS） were compared with histologic results. Using χ2test to compare theaccuracy, there was statistically significant difference (a=0.05, P <0.05). The ROC curvewas build to assess the diagnostic performance of the different methods of checking andanalysis of its sensitivity, specificity, positive predictive value, negative predictive valueindicators.Results：The accuracy of SHG and TVS in the diagnosis of uterine endometrialpolyps were91.57%,78.31%. The difference between SHG and TVS had statisticalsignificance（P<0.05）；The accuracy of SHG and HS in the diagnosis of uterineendometrial polyps were91.57%,92.77%. the difference between SHG and HS had nostatistical significance（P>0.05）. ROC curve showed: the sensitivity, specificity, positivepredictive value, negative predictive value of SHG in the diagnosis of uterine endometrial polyps were96.67%,78.26%,92.06%,90.00%; the sensitivity, specificity, positivepredictive value, negative predictive value of TVS in the diagnosis of uterine endometrialpolyps were81.67%,69.57%,87.50%,59.26%; the sensitivity, specificity, positivepredictive value, negative predictive value of HS in the diagnosis of uterine endometrialpolyps were93.33%,91.30%,96.55%,84.00%. ROC analysis indicated that the area underthe SHG curve of0.875is significantly higher than the area under the TVS curve of0.756and is close to the area under the HS curve of0.923.Conclusion：①SHG was non-invasive and safe, it was more valuable than TVS indiagnosing uterine endometrial polyps.②The accuracy rate of SHG in diagnosingedometrial polyps was close to that of HS in apprppriate time.③SHG can provide muchmore information, which can help clinical doctors in choosing processing methods andoperation methods, and it also can make some people avoid unnecessary hysteroscopy.