Accuracy of Transvaginal Ultrasonography for Detecting Intrauterine Lesions at a Taiwan Medical Center: A Correlation with Ultrasound and Hysteroscopic Histopathology

Abstract

Transvaginal ultrasound (TVUS) can detect intrauterine benign focal pathological mass lesions such as polyps and measure endometrial thickness (ET) in patients with or without abnormal uterine bleeding (AUB). Our study assessed TVUS images for evaluating and measuring benign focal intrauterine lesions. Patients and methods: This study retrospectively analyzed symptoms, ultrasound findings, and final histopathological reports for 184 women who underwent operative hysteroscopy in 2011 at a single medical center in Taiwan. Patients were chosen if their TVUS images showed benign focal intrauterine pathological masses. Results: Sonographic reports corresponding with hysteroscopic pathologic examinations were reported in 184 patients. There were 36 patients with positive sonographic reports that did not correlate with their pathologic examination results. Another 36 patients, however, had negative sonographic reports but positive pathologic examination results, with a sensitivity of 72.9% and positive predictive value of 72.9%. An ET cut-off value above 9 mm had a poorer sensitivity (74.4%) for detecting focal benign intrauterine lesions and an ET cut-off value above 8 mm had a higher sensitivity of 86.5% for detecting focal benign intrauterine lesions. In the AUB status group, calculated Chi-square test (χ2) results showed that the intrauterine benign focal lesion detection rate did not change statistically even after controlling ET. Conclusion: TVUS had a sensitivity of 72.9% for diagnosing focal lesions. An ET ≥ 8 mm had a lower sensitivity for diagnosing benign intrauterine focal lesions. In our retrospective study group, AUB was not a good predictor for diagnosing focal intrauterine lesions even after treating ET as a fixed variance.

Keywords

• endometrial lesion
• hysteroscopy
• transvaginal sonography