Vahdat Mansoureh, Sariri Elaheh, Kashanian Maryam, Najmi Zahra, Mobasseri Alireza, Marashi Mahjabin, Mohabbatian Behnaz, Ariana Shideh, Moradi Yousef
MD, Assistant Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran.
MD, Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2016 Apr 10;30:352. eCollection 2016.
Müllerian anomalies are associated with infertility. Hysteroscopy as the gold standard for evaluating Müllerian anomalies is an invasive, expensive and risky procedure which requires enough experience. Transvaginal sonography (TVS) and hysterosalpingography (HSG) are less invasive procedures, but there is little known about the accuracy of these tests. The aim of this study was to evaluate the accuracy of the combination of TVS and HSG with hysteroscopy as the gold standard.
Medical records of infertile women who were undertaken all three diagnostic modalities were reviewed to analyze their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Ninety-nine infertile women were assessed with a mean±SD age of 29.1±6.47 years, mean±SD duration of themarriage of 8.9±10.28 years, and mean±SD duration of infertility of 5.6± 4.16 years. The sensitivity, specificity, PPV, and NPV of TVS were 98.55%, 30%, 76.4%, and 90%, respectively. HSG had a sensitivity of 95.6%, specificity of 60%, PPV of 84.62%, and NPV of 85.71%.When both modalities were combined, the sensitivity, specificity, PPV, and NPV were 94.2, 66.67, 86.67, and 83.33%, respectively. The diagnostic accuracy of single TVS, HSG or combined techniques was statistically similar that was equal to 77.7, 84.8 and 85.8 % respectively.
The accuracy of combination of two diagnostic modalities, 2D TVS and HSG is not higher than HSG alone for assessing uterine malformation in infertile women.
苗勒管异常与不孕相关。宫腔镜检查作为评估苗勒管异常的金标准，是一种侵入性、昂贵且有风险的操作，需要足够的经验。经阴道超声检查（TVS）和子宫输卵管造影（HSG）是侵入性较小的检查，但这些检查的准确性鲜为人知。本研究的目的是以宫腔镜检查为金标准，评估TVS和HSG联合检查的准确性。
回顾接受了所有三种诊断方法的不孕女性的病历，分析其敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
对99例不孕女性进行了评估，其平均年龄±标准差为29.1±6.47岁，平均婚龄±标准差为8.9±10.28年，平均不孕时间±标准差为5.6±4.16年。TVS的敏感性、特异性、PPV和NPV分别为98.55%、30%、76.4%和90%。HSG的敏感性为95.6%，特异性为60%，PPV为84.62%，NPV为85.71%。当两种检查方法联合使用时，敏感性、特异性、PPV和NPV分别为94.2%、66.67%、86.67%和83.33%。单一TVS、HSG或联合技术的诊断准确性在统计学上相似，分别为77.7%、84.8%和85.8%。
对于评估不孕女性的子宫畸形，二维TVS和HSG这两种诊断方法联合使用的准确性并不高于单独使用HSG。
