Diagnostic Value Of Transvaginal Sonography And Hysteroscopy For Abnormal Uterine Bleeding

Purposes: To discuss the value of transvaginal sonography and hysteroscopy indiagnosis of abnormal uterine bleeding.Methods: Contrast the1032patients of Shanghai sixth people’s hospital in january2012－December2013because of AUB，which were examined with TVS、HS and biopsy.The characteristics of TVS、HS were analysed，which were compared with pathologicalresults. To calculate the sensivity、specificity、positive and negative predictive values andanalyse the diagnostic accordance rate、the misdiagnosis rate、the missed diagnosis rate ofAUB.Results: TVS in1032patients，967（93.70%）cases diagnosed as abnormal, with940(91.09%)cases confirmed by pathology,65(6.30%) cases in the diagnosis of no exception,35(3.39%) cases confirmed by pathology. Hysteroscopy examination of982(95.16%) casesdiagnosed as abnormal, of which964(93.41%)cases confirmed by pathology,50(4.84%)cases without exception,44(4.26%) cases confirmed by pathology. The sensitivity、specificity、positive and negative predictive values of HS(99.38%、70.97%、98.17%、88.00%) are higher than those of TVS（96.91%、56.45%、97.21%、53.85%). Hysteroscopyfor submucosal myoma、intimal hyperplasia、atrophic endometrium、endometritis、normalendometrium and others (uterine malformation、 pregnancy-related、IUD)（81.46%、58.25%、73.53%、76.92%、70.97%、100%）compared with TVS（75.50%、45.63%、61.76%、69.23%、56.45%、94.59%），there was no significant difference（P＞0.05）；endometrial polyp、endometrial cancer（85.92%、82.69%） compared with TVS（62.27%、63.46%），P＜0.05.Conclusion: HS can observe uterine cavity and endometrial panorama, with highspecificity and negative predictive value,especially in the diagnosis of endometrial polyp and endometrial cancer. TVS is non-invasive、convenient and low-cost in diagnosis ofAUB, but the specificity and negative predictive value are low,so it can be used as thepreferred way, combined with HS, in order to improve the diagnosis of AUB.