Diagnostic Accuracy of Hysterosonography in Diagnosis of Uterine Lesions by Taking Hysteroscopy as Gold Standard

Abstract

Background and Aim: Evaluation of uterine abnormalities is infertility core partto be assessed in impaired reproduction cases. Uterine abnormalities can be assessed by various radiological imaging modalities such as transvaginal sonography, hysterosalpingography and hysterosonography. The current study aims to evaluate the diagnostic accuracy of hysterosonography in diagnosis of uterine lesions by taking hysteroscopy as gold standard. Materials and Methods: This observation-based cross-sectional study was carried out on 108 reproductive-age women at the Department of Obstetrics and Gynecology of Liaquat University of Medical and Health Sciences, Jamshoro during the period from January 2020 to June 2020.These women had uterine abnormalities such as recurrent pregnancy loss, abnormal uterine bleeding, infertility, and clinically diagnosed lesions of intrauterine. All individuals underwent hysteroscopy evaluation.Global sensitivity analysis technique was used to calculate the bias-adjusted specificity and sensitivity of hysterosonography. Uterine abnormalities were assessed by hysteroscopy taking it as a gold standard. SPSS version 20 was used for data analysis. Results:The mean age of the women was 27.3 ± 5.63 with age range 20 to 34 years and parity ranged from 0 to 5. Out of 108 patients, 49 (45.4%) had positive findings of abnormal uterine lesions including myomas in 13 (12.3%), polyps 17 (15.7%), uterine septum 7 (6.4%) and intrauterine adhesions 12 (11.1%). Among all, forty-nine (45.4%) women had infertility, previous cesarean section 20 (19.1%), recurrent pregnancy loss 18 (16.6%), and menstrual disorders 21 (19.4%).Diagnostic accuracy of hysterosonography in terms of specificity, sensitivity, and Positive prediction value (PPV) was 94%, 77%, and 74% for uterine lesions respectively while taking hysteroscopy as a gold standard. Conclusion: The present study concluded that uterine lesions among reproductive-age women could be easily assessed with higher accuracy of hysterosonography. Based on the specificity and sensitivity of hysteroscopy as a gold standard for hysterosonography is the most reliable, safe and accurate diagnostic technique for uterine lesions. Keywords:Hysterosonography, Uterine lesions