Choudry Abeera, Shukr Irfan, Khan Sumaira, Hafeez Humaira, Jamal Shahid, Anwer Ambreen
Department of Gynaecology, Combined Military Hospital, Multan.
J Coll Physicians Surg Pak. 2010 Sep;20(9):571-5.
To validate the diagnostic efficacy of saline infusion sonohysterography (SIS) in the evaluation of uterine cavity,in women with postmenopausal bleeding and endometrial thickness (3) 5 mm.
Cross-sectional study.
Military Hospital, Rawalpindi, from March 2005 to July 2008 and Combined Military Hospital, Multan, from September 2008 to June 2009.
Seventy seven eligible participants included women complaining of postmenopausal bleeding were included; out of whom 69 completed the procedure satisfactorily. Pain scores during procedure were assessed to determine patient acceptability. Following saline infusion sonohysterography all patients also underwent an out door pipelle endometrial biopsy in a one-stop postmenopausal bleed clinic. Findings of sonohysterography were compared with hysteroscopy/hysterectomy specimen.
Majority of the patients 34 (49.2%) experienced no pain during the procedure, 51 (74%) women had a positive SIS and the findings were negative in 18 (26%) patients. The commonest abnormal finding on SIS was focal thickening in 23 (32%) and endometrial polyp in 12 (17%) cases. Saline infusion hysterosonography picked up 3 cases of false positive polyps (5.8%) and missed a case of submucous fibroid near cervix (1.8%). Upon comparison of findings of hysteroscopy and hysterectomy in 53 cases, there was complete agreement in a total of 43 (88%) cases. The sensitivity of sonohysterography was 92% and specificity was 78%. All the ladies with abnormal SIS had diagnostic or therapeutic procedures and finally only 24 (35%) were managed on conservative follow-up. Normal SIS led to conservative management in 16 (88%).
Sonohysterography in combination with endometrial biopsy is a useful technique useful for the evaluation of postmenopausal bleeding. Patient acceptability and diagnostic capability is high and it reduces demand for hysteroscopy.
验证生理盐水灌注超声子宫造影（SIS）对绝经后出血且子宫内膜厚度≥5mm的女性宫腔评估的诊断效能。
横断面研究。
2005年3月至2008年7月在拉瓦尔品第军事医院，以及2008年9月至2009年6月在木尔坦联合军事医院。
纳入77名符合条件的主诉绝经后出血的女性；其中69名顺利完成该检查。评估检查过程中的疼痛评分以确定患者的接受程度。在生理盐水灌注超声子宫造影检查后，所有患者还在一站式绝经后出血门诊接受了门诊宫腔内膜活检。将超声子宫造影的结果与宫腔镜检查/子宫切除标本进行比较。
大多数患者34名（49.2%）在检查过程中无疼痛，51名（74%）女性SIS结果为阳性，18名（26%）患者结果为阴性。SIS最常见的异常发现是局灶性增厚23例（32%）和子宫内膜息肉12例（17%）。生理盐水灌注子宫超声造影检出3例假阳性息肉（5.8%），漏诊1例宫颈附近黏膜下肌瘤（1.8%）。在53例宫腔镜检查和子宫切除结果的比较中，共有43例（88%）完全一致。超声子宫造影的敏感性为92%，特异性为78%。所有SIS异常的女性均接受了诊断或治疗程序，最终只有24名（35%）进行保守随访管理。SIS正常的患者中有16名（88%）进行了保守治疗。
超声子宫造影联合子宫内膜活检是评估绝经后出血的有用技术。患者接受度和诊断能力高，且减少了对宫腔镜检查的需求。
