Ahmadi Firoozeh, Rashidy Zohreh, Haghighi Hadieh, Akhoond Mohamadreza, Niknejadi Maryam, Hemat Mandana, Shamsipour Mansour
Department of Reproductive Imaging at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Department of Statistics, Mathematical Science and Computer Faculty, Shahid Chamran University, Ahvaz, Iran.
Iran J Reprod Med. 2013 Dec;11(12):977-82.
Assessment of uterine abnormalities is a core part in infertility evaluation.
The aim of this study was to evaluate the sensitivity and specificity of three-dimensional hysterosonography (3-DHS) in the diagnosis of uterine abnormalities in infertile women.
The infertile women who visited Royan Institute and referred to 3-DHS consecutively, prior to in vitro fertilization, from 2010-2011 included in this cross-sectional study. For patients who underwent hysteroscopy in addition to 3-DHS (214/977), the verification bias adjusted sensitivity and specificity of 3-DHS which were calculated by global sensitivity analysis method. Hysteroscopy was used as the gold standard for diagnosis of uterine abnormalities. Histological diagnosis of resected endometrial tissues by hysteroscopy was assessed and the adjusted sensitivity and specificity of 3-DHS and hysteroscopy in detection of polyp or hyperplasia were determined. Histopathologic results were considered as the gold standard for diagnosis of polyp or hyperplasia.
The overall sensitivity and specificity for 3-DHS in diagnosis of uterine anomalies considering hysteroscopy as the gold standard were 68.4% and 96.3% respectively. Sensitivity and specificity of hysteroscopy in diagnose of polyp or hyperplasia was calculated at 91.3% and 81.4% respectively. Sensitivity and specificity of 3-DHS in diagnosis polyps or hyperplasia was calculated at 91.4% and 80.2 % respectively.
The results of present study proved that, compared to hysteroscopy; 3-DHS has a reliable specificity for diagnosis of uterine abnormalities. Sensitivity and specificity of 3-DHS and hysteroscopy in detecting polyp or hyperplasia regarding histopathology as the gold standard was the same.
子宫异常评估是不孕症评估的核心部分。
本研究旨在评估三维子宫超声造影（3-DHS）在诊断不孕女性子宫异常中的敏感性和特异性。
本横断面研究纳入了2010年至2011年期间连续前往罗扬研究所并在体外受精前接受3-DHS检查的不孕女性。对于除3-DHS外还接受宫腔镜检查的患者（214/977），采用全局敏感性分析方法计算3-DHS经验证偏倚调整后的敏感性和特异性。宫腔镜检查被用作子宫异常诊断的金标准。评估宫腔镜切除的子宫内膜组织的组织学诊断，并确定3-DHS和宫腔镜在检测息肉或增生方面的调整后敏感性和特异性。组织病理学结果被视为息肉或增生诊断的金标准。
以宫腔镜检查为金标准，3-DHS诊断子宫异常的总体敏感性和特异性分别为68.4%和96.3%。宫腔镜诊断息肉或增生的敏感性和特异性分别计算为91.3%和81.4%。3-DHS诊断息肉或增生的敏感性和特异性分别计算为91.4%和80.2%。
本研究结果证明，与宫腔镜检查相比，3-DHS在诊断子宫异常方面具有可靠的特异性。以组织病理学为金标准，3-DHS和宫腔镜在检测息肉或增生方面的敏感性和特异性相同。
