Objective: To compare the diagnostic accuracy and acceptability of saline infusion sonohysterography (SIS), and hysteroscopy for detecting intracavitary abnormalities in women with abnormal uterine bleeding. Methods: Seventy-eight patients with abnormal uterine bleeding were selected from the Department of Obstetrics and Gynecology in Chonnam University Hospital. The findings at SIS were compared with the hysteroscopic and histologic findings. The agreement of diagnosis between SIS and hysteroscopy was calculated. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Results: SIS had a sensitivity of 84% and a specificity of 85% for a diagnosis of endometrial polyp. Hysteroscopy had a sensitivity of 86% and a specificity of 96% for diagnosis of endometrial polyp. SIS had a sensitivity of 75% and a specificity of 86% for a diagnosis of submucosal myoma. Hysteroscopy had a sensitivity of 100% and a specificity 99% for a diagnosis of submucosal myoma. SIS had a sensitivity of 91% and a specificity of 96% for a diagnosis of submucosal myoma. Hysteroscopy had a sensitivity of 100% and a specificity 91% for a diagnosis of endometrial hyperplasia. Conclusions: The diagnostic accuracy of SIS was significant to that of hysteroscopy in diagnosing intracavitary abnormalities, Moreover, SIS in a safe, convenient, cost effective, easily accessible and acceptable investigative modality.

Objective: To compare the diagnostic accuracy and acceptability of saline infusion sonohysterography (SIS), and hysteroscopy for detecting intracavitary abnormalities in women with abnormal uterine bleeding. Methods: Seventy-eight patients with abnormal uterine bleeding were selected from the Department of Obstetrics and Gynecology in Chonnam University Hospital. The findings at SIS were compared with the hysteroscopic and histologic findings. The agreement of diagnosis between SIS and hysteroscopy was calculated. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Results: SIS had a sensitivity of 84% and a specificity of 85% for a diagnosis of endometrial polyp. Hysteroscopy had a sensitivity of 86% and a specificity of 96% for diagnosis of endometrial polyp. SIS had a sensitivity of 75% and a specificity of 86% for a diagnosis of submucosal myoma. Hysteroscopy had a sensitivity of 100% and a specificity 99% for a diagnosis of submucosal myoma. SIS had a sensitivity of 91% and a specificity of 96% for a diagnosis of submucosal myoma. Hysteroscopy had a sensitivity of 100% and a specificity 91% for a diagnosis of endometrial hyperplasia. Conclusions: The diagnostic accuracy of SIS was significant to that of hysteroscopy in diagnosing intracavitary abnormalities, Moreover, SIS in a safe, convenient, cost effective, easily accessible and acceptable investigative modality.

목적: 비정상 자궁출혈 환자들의 자궁강 내 병변의 진단방법에 있어 식염수 주입 초음파 자궁조영술 (saline infusion sonohysterography, SIS)과 자궁경 검사 (hysteroscopy)를 비교하여 자궁강 내 병변의 적절한 진단법 및 어떤 방법이 더 유용한지 알아보고자 하였다. 방법: 2005년 6월부터 2006년 6월까지 만 13개월 동안 비정상 자궁출혈을 주소로 전남대병원 산부인과를 방문하여 식염수 주입 초음파 자궁조영술과 자궁경 검사를 시행한 78예를 대상으로 하였으며, 모두 식염수 주입 초음파 자궁조영술과 자궁경 검사를 시행하였으며, 자궁경 검사 시 조직 생검을 시행하여, 모든 결과는 조직병리 소견으로 분석하였다. 결과: 식염수 주입 초음파 자궁조영술과 자궁경 검사를 조직병리 소견과 비교했을 때 각각의 민감도와 특이도를 살펴보면, 자궁내막 용종의 경우 식염수 주입 초음파 자궁조영술은 84%의 민감도와 85%의 특이도를 나타내었고, 자궁경 검사의 경우에는 각각 86%와 96%로 나타났다. 점막하 근종의 경우에 식염수 주입 초음파 자궁조영술은 75%의 민감도와 86%의 특이도를 나타내었고, 자궁경 검사는 100%와 99%였다. 자궁내막 증식증의 경우는 식염수 주입 초음파 자궁조영술에서 91%의 민감도와 96%의 특이도를 나타냈고, 자궁경 검사에서는 각각 100%와 91%로 나타났다. 결론: 식염수 주입 초음파 자궁조영술은 자궁내막의 병변을 진단하는데 있어서 더 간편하고 안전하며, 보다 침습적인 진단적 자궁경 검사를 피할 수 있으며, 자궁경 검사에 뒤지지 않을 정도로 정확성이 높아서, 자궁강 내 병변의 진단방법으로 유용할 것으로 생각된다.

식염수 주입 초음파 자궁조영술, 자궁경 검사