Boudaya Fethia, Jenayah Amel Achour, Saoudi Sarah, Gharsa Anissa, Gharbi Eya, Sfar Ezzeddine, Chelli Dalenda
Service de Gynécologie Obstétrique «A», Centre de Maternité et de Néonatologie de Tunis, Tunisie.
Pan Afr Med J. 2016 Jun 30;24:175. doi: 10.11604/pamj.2016.24.175.7361. eCollection 2016.
Post-menopausal metrorrhagias represent a frequent reason for consultation in gynecology. Our study aims to evaluate the contribution of pelvic ultrasonography in the exploration of endocavitary lesions in people experiencing this symptom and to compare the results found with those of hysteroscopy and histology. This was an analytic retrospective study of 33 cases referred for evaluation of postmenopausal metrorrhagias at the department of gynecology and obstetrics «A» in the Center of Maternity and Neonatology of Tunis in 2012. All patients underwent pelvic ultrasonography and diagnostic hysteroscopy. We analyzed and compare the data obtained with pelvic ultrasonography, hysteroscopy and histological examination. The average age of our patients was 57.78 years and the average age of menopause was 48.36 years. The confrontation between ultrasonographic and histological data showed that ultrasonography has a sensitivity of 80.6%, a specificity of 79.38%, positive predictive value (PPV) of 67.03% and negative predictive value (NPV) of 91.54%. With respect to hysteroscopy these values were 84,44%, 82,72%, 69,93% and 92,65% respectively. Performance level for each exploratory diagnostic tool varied according to the lesion which caused metrorrhagias and generally hysteroscopy was more reliable in the exploration of metrorrhagias than ultrasonography: Youden index 0.67 against 0.59. Our results confirmed data published in the literature that assigns to hysteroscopy a greater reliability compared to pelvic ultrasonography in the diagnosis of endocavitary lesions causing postmenopausal metrorrhagias.
绝经后子宫出血是妇科门诊常见的就诊原因。我们的研究旨在评估盆腔超声检查在探索出现该症状患者的宫腔内病变中的作用，并将所得结果与宫腔镜检查和组织学检查结果进行比较。这是一项回顾性分析研究，对2012年突尼斯母婴中心妇产科“A”转诊来评估绝经后子宫出血的33例病例进行研究。所有患者均接受了盆腔超声检查和诊断性宫腔镜检查。我们分析并比较了盆腔超声检查、宫腔镜检查和组织学检查所获得的数据。我们患者的平均年龄为57.78岁，平均绝经年龄为48.36岁。超声检查数据与组织学数据对比显示，超声检查的敏感性为80.6%，特异性为79.38%，阳性预测值（PPV）为67.03%，阴性预测值（NPV）为91.54%。与宫腔镜检查相比，这些值分别为84.44%、82.72%、69.93%和92.65%。每种诊断性检查工具的性能水平因引起子宫出血的病变而异，一般来说，宫腔镜检查在子宫出血的探查中比超声检查更可靠：约登指数分别为0.67和0.59。我们的结果证实了文献中发表的数据，即在诊断导致绝经后子宫出血的宫腔内病变方面，与盆腔超声检查相比，宫腔镜检查具有更高的可靠性。
