Department of Obstetrics and Gynecology, University Hospitals, and Department of Electrical Engineering, ESAT-SCD, Katholieke Universiteit Leuven, Leuven, Belgium.
Fertil Steril. 2011 Jan;95(1):285-8. doi: 10.1016/j.fertnstert.2010.04.074. Epub 2010 Jul 7.
To compare saline infusion sonography (SIS) with gel instillation sonography (GIS) in terms of feasibility and diagnostic accuracy.
Prospective cohort study.
Leuven University bleeding clinic.
PATIENT(S): A total of 804 patients: two consecutive cohorts of 402 women undergoing SIS or GIS.
INTERVENTION(S): Vaginal ultrasound (n=804) followed by SIS (n=402) or GIS (n=402); office hysteroscopy in 685 patients, and endometrium sampling in 487 patients; surgery in 274 women: operative hysteroscopy (n=230) or hysterectomy (n=44).
MAIN OUTCOME MEASURE(S): Patients' characteristics, technical failure rates, and final diagnosis. Pathology was defined as endometrial hyperplasia, polyp, cancer, or intracavitary myomas.
RESULT(S): The technical failure rate (difference between proportions and confidence interval) was 5.0% for SIS versus 1.8% for GIS, respectively (3.21; [0.69-5.95]). Failure due to inadequate distension was 1.5% versus 0.3% for SIS and GIS, respectively (1.25; [-0.16-2.99]). Pathology was diagnosed in 180 patients (49%) of the SIS group versus 147 patients of the GIS group (40.2%) (8.88; [1.69-15.95]). The sensitivity was 77.8% and 85.0%, respectively (NS). The negative predictive value was 79.1% for SIS and 88.6% for GIS (9.54; [2.17-16.89]).
CONCLUSION(S): Gel instillation sonography is a feasible, accurate alternative for SIS in the evaluation of women with abnormal bleeding, and has fewer technical failures.
比较生理盐水灌注超声（SIS）与凝胶灌注超声（GIS）的可行性和诊断准确性。
前瞻性队列研究。
鲁汶大学出血诊所。
共 804 例患者：连续 2 个队列各 402 例患者分别行 SIS 或 GIS。
阴道超声（n=804），随后行 SIS（n=402）或 GIS（n=402）；685 例行宫腔镜检查，487 例行子宫内膜活检；274 例患者行手术治疗：宫腔镜手术（n=230）或子宫切除术（n=44）。
患者特征、技术失败率和最终诊断。病理诊断为子宫内膜增生、息肉、癌症或宫腔内肌瘤。
SIS 的技术失败率（比例差异及其置信区间）为 5.0%，GIS 为 1.8%（3.21；[0.69-5.95]）。SIS 和 GIS 因膨胀不全而导致技术失败的比例分别为 1.5%和 0.3%（1.25；[-0.16-2.99]）。SIS 组 180 例（49%）患者和 GIS 组 147 例（40.2%）患者有病理学诊断（8.88；[1.69-15.95]）。SIS 的敏感度为 77.8%，GIS 为 85.0%（NS）。SIS 的阴性预测值为 79.1%，GIS 为 88.6%（9.54；[2.17-16.89]）。
GIS 是一种可行且准确的 SIS 替代方法，可用于评估异常子宫出血患者，且技术失败率更低。
