SALINE INFUSION SONOGRAPHY: A VALID TOOL FOR DETECTION OF INTRAUTERINE PATHOLOGY IN WOMEN WITH ABNORMAL UTERINE BLEEDING

Abstract

ABSTRACT:

OBJECTIVE:

To evaluate the diagnostic accuracy of transvaginal ultrasound and saline infusion sonography for the detection of intra-cavity lesions of uterus using histopathology on hysterectomy specimens as the gold standard.

STUDY DESIGN:

Cross-sectional (validation) study.

Place & duration of study:

Department of obstetrics & gynecology, Madina Teaching Hospital, Faisalabad from January 18, 2022 to September 30, 2022.

METHODOLOGY:

Sixty patients with abnormal uterine bleeding and postmenopausal bleeding were included in the study. All participants were evaluated by transvaginal ultrasound (TVS) and saline infusion sonography (SIS) to detect uterine cavity pathologies. The findings at TVS and SIS were compared with the findings of histopathology on hysterectomy specimens. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated.

RESULTS:

Mean age was 49.68±5.9 years. Polyps, proliferative endometrium, endometrial hyperplasia and sub mucous fibroid are noted in 32 (53.3%), 16 (26.7%), 3 (5%) and 9 (15%) patients,  Sensitivity, specificity, PPV, NPV and diagnostic accuracy of TVS are 61.36%, 100%, 100%, 48.48% and 71.67% and for SIS are 88.64%, 100%, 100%, 76.19% and 91.67% respectively.

CONCLUSION:

SIS is highly sensitive and specific investigation to detect intra-cavity abnormalities of uterus. SIS can be used as an alternative investigation tool in low resource settings whenever hysteroscopy in not readily available.

KEY WORDS: Uterine cavity lesions, sensitivity, specificity, saline infusion sonography