COMPARISON OF DIAGNOSTIC TECHNIQUES USED IN THE DIFFERENTIAL DIAGNOSIS OF ENDOMETRIAL PATHOLOGIES PRESENTING WITH AN ABNORMAL UTERINE BLEEDING

Abstract

Introduction: Transvaginal ultrasonography ( TVUSG ) examination, dilatation and curettage ( D&C ) approach and hysteroscopic assesment are frequently used in examination of the abnormal uterine bleeding ( AUB ). The specisific test for detection of the AUB is histopathological evaluation. The study aimed to check the exactness of TVUSG, D&C and hysteroscopy for differential diagnosis of the AUB. Patients and Methodology: Subjects with AUB, who were supposed to have an endometrial pathology on TVUSG, D&C or hysteroscopy, were included in this retrospective study. Our retrospective study was conducted in 160 patients who were admitted to our clinic with complaint of abnormal uterine bleeding. The final pathological diagnosis was accepted as the reference test and sensitivity and specifity of the D&C, hysteroscopy and TVUSG was checked with the pathological diagnosis. Results: Hysteroscopy combined with biopsy provieded highest correlation with the histopathological evaluation. However, the statistical values obtained with TVUSG was comparable to that of the hysteroscopy alone and D&C but lower than that of the hysteroscopy combined with biopsy. Conclusion: Transvaginal ultrasound is a readily available and reproducible imaging technique for the evalution of the endometrial pathologies leading to the AUB. However, the specificity of the TVUSG is quite low. Among the methods used to correctly identify the endometrial pathologies in our study population, the highest sensitivity and specificity was obtained with hysterosopy combined with the biopsy. Nevertheless, TVUSG provides similar statistical values compared to hysteroscopy alone and D&C.

Keywords

• abnormal uterine bleeding
• transvaginal ultrasound
• dilatation
• curettage
• hysteroscopy

Anormal Rahim Kanaması İle Başvuran Endometrial Patolojilerin Ayırıcı Tanısında Farklı Tanı Tekniklerinin Karşılaştırılması

Abstract

Giriş: Transvajinal ultrasonografi ( TVUSG ) muayenesi, dilatasyon ve küretaj ( D&C ) yaklaşımı ve histeroskopik değerlendirme anormal uterin kanamanın ( AUB ) incelenmesinde sıklıkla kullanılmaktadır. AUB tespiti için özel test histopatolojik değerlendirmedir. Çalışma, AUB'nin ayırıcı tanısı için TVUSG, D&C ve histeroskopinin doğruluğunu kontrol etmeyi amaçladı. Yöntemler: Bu retrospektif çalışmaya TVUSG, D&C veya histeroskopide endometriyal patoloji olması beklenen AUB'li olgular dahil edildi. Son patolojik tanı referans test olarak kabul edildi ve patolojik tanı ile D&C, histeroskopi ve TVUSG'nin duyarlılık ve özgüllüğü kontrol edildi. Sonuçlar: Biyopsi ile kombine histeroskopi, histopatolojik değerlendirme ile en yüksek korelasyonu sağladı. Bununla birlikte, TVUSG ile elde edilen istatistiksel değerler, tek başına histeroskopi ve D&C ile karşılaştırılabilir ancak biyopsi ile kombine histeroskopininkinden daha düşüktü. Sonuç: Transvajinal ultrason, AUB'ye yol açan endometriyal patolojilerin değerlendirilmesi için kolaylıkla temin edilebilen ve tekrarlanabilir bir görüntüleme tekniğidir. Ancak, TVUSG'nin özgüllüğü oldukça düşüktür. Çalışma popülasyonumuzdaki endometriyal patolojileri doğru bir şekilde tanımlamak için kullanılan yöntemler arasında en yüksek duyarlılık ve özgüllük biyopsi ile kombine histeroskopi ile elde edildi. Bununla birlikte, TVUSG, tek başına histeroskopi ve D&C ile karşılaştırıldığında benzer istatistiksel değerler sağlar.

Keywords

• anormal uterine kanama
• transvajinal ultrason
• dilatasyon
• küretaj
• histeroskopi

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