How Well Does Sonohysterography Match Up Against the Gold Standard of Hysteroscopy?
BACKGROUND AND PURPOSE:
Bittencourt et. al. (Ultrasound in Obstetrics and Gynecology, 2017) analyzed the diagnostic accuracy of two- and three- dimensional saline contrast sonohysterography (SCSH) against hysteroscopy for the detection of endometrial polyps and submucosal uterine leiomyomas in women of reproductive age and abnormal uterine bleeding
Systematic review and meta-analysis of 1398 citations and 5 diagnostic studies comparing 2D and/or 3D SCSH with hysteroscopy
Pooled sensitivity, specificity and positive (LR+) and negative (LR-) likelihood ratios of SCSH in the detection of uterine cavity abnormalities were calculated
Specificity of 81%
LR+ of 5.42
LR- of 0.10
ROC curves AUC 0.97 ± 0.02
Submucousal uterine leiomyomas
LR+ of 4.25
LR- of 0.11
ROC curves AUC 0.97 ± 0.03
3D- SCSH could not be compared due to high heterogeneity in subject type and methodology
2D-SCSH was a highly sensitive method of detecting endometrial polyps and submucosal uterine leiomyomas
2D-SCSH is a potential first-line diagnostic method for women with abnormal uterine bleeding (AUB)
Lower costs, less discomfort, and wide availability also make SCSH a good first line test
More studies are needed on 3D-SCSH predictive power
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