Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Minim Invasive Gynecol. 2011 Jan-Feb;18(1):54-8. doi: 10.1016/j.jmig.2010.08.697.
To compare the diagnostic value of 2-dimensional (2D) and 3-dimensional (3D) sonohysterography (SHG) and outpatient hysteroscopy (OH) in detecting intrauterine lesions in infertile women.
Comparative, observational, cross-sectional study (Canadian Task Force Classification II-2).
University hospital.
One hundred eighty women with a normal uterine cavity at transvaginal ultrasound and hysterosalpingography (HSG) underwent infertility workup at our outpatient clinic.
All patients underwent 2D-SHG, 3D-SHG, and OH.
Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 2D-SHG and 3D-SHG were compared with OH in detecting intrauterine lesions. For 2D-SHG, sensitivity was 0.70 (95% confidence interval [CI], 0.49-0.85), specificity was 1.0 (95% CI, 0.96-1.0), PPV was 1.0 (95% CI, 0.79-1.0), NPV was 0.95 (95% CI, 0.9-0.97), and accuracy was 95.5%. For 3D-SHG, sensitivity was 0.92 (95% CI, 0.74-0.98), specificity was 1.0 (95% CI, 0.97-1.0), PPV was 1.0 (05% CI, 0.83-1.0), NPV was 0.98 (95% CI, 0.95-0.99), and accuracy was 98.8%. For OH, sensitivity was 1.0 (95% CI, 0.85-1.0), specificity was 1.0 (95% CI, 0.97-1.0), PPV was 1.0 (95% CI, 0.84-1.0), NPV was 1.0 (0.97-1.0), and accuracy was 100%. Thus, 3D-SHG is comparable to OH in diagnosing intrauterine lesions (p = .23), and both are superior to 2D-SHG (p <0.001).
The diagnostic value of 3D-SHG is comparable to OH in detecting intrauterine lesions, and both are superior to 2 D-SHG. 3D-SHG should be included in the infertility workup even in women with a normal uterine cavity at transvaginal ultrasound or hysterosalpingography.
比较二维（2D）和三维（3D）超声子宫造影（SHG）与门诊宫腔镜（OH）诊断不孕女性宫腔内病变的诊断价值。
对比观察性、横断面研究（加拿大任务组分类 II-2）。
大学医院。
180 名经阴道超声和子宫输卵管造影（HSG）检查子宫腔正常的不孕女性在我院门诊进行不孕检查。
所有患者均行 2D-SHG、3D-SHG 和 OH。
比较 2D-SHG 和 3D-SHG 与 OH 检测宫腔内病变的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性。对于 2D-SHG，敏感性为 0.70（95%置信区间[CI]，0.49-0.85），特异性为 1.0（95%CI，0.96-1.0），PPV 为 1.0（95%CI，0.79-1.0），NPV 为 0.95（95%CI，0.9-0.97），准确性为 95.5%。对于 3D-SHG，敏感性为 0.92（95%CI，0.74-0.98），特异性为 1.0（95%CI，0.97-1.0），PPV 为 1.0（05%CI，0.83-1.0），NPV 为 0.98（95%CI，0.95-0.99），准确性为 98.8%。对于 OH，敏感性为 1.0（95%CI，0.85-1.0），特异性为 1.0（95%CI，0.97-1.0），PPV 为 1.0（95%CI，0.84-1.0），NPV 为 1.0（0.97-1.0），准确性为 100%。因此，3D-SHG 在诊断宫腔内病变方面与 OH 相当（p=0.23），且均优于 2D-SHG（p＜0.001）。
3D-SHG 在检测宫腔内病变方面与 OH 相当，且均优于 2D-SHG。即使在经阴道超声或 HSG 检查子宫腔正常的女性中，也应将 3D-SHG 纳入不孕检查。
