Radiology · 1996
Value of sonohysterography in the diagnosis and management of abnormal uterine bleeding.
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Lev-Toaff A S, Toaff M E, Liu J B, Merton D A, Goldberg B B
Аннотация
PURPOSE: To assess the value of sonohysterography in the diagnosis and management of abnormal uterine bleeding.
MATERIALS AND METHODS: Sonohysterography was performed in 28 women (aged 29-55 years) in whom transvaginal sonography (TVS) suggested an abnormal endometrial echo (n = 14) or fibroids (n = 14). Its effect on diagnosis and treatment was studied.
RESULTS: In the patients with an abnormal endometrial echo, sonohysterography depicted endometrial polyps (n = 9), intracavitary fibroids (n = 3), placental polyp (n = 1), and a normal cavity (n = 1). Hysteroscopic resection resolved the bleeding in 11 of 14 patients; surgery was obviated in one. In the group with fibroids, sonohysterography depicted small submucous fibroids amenable to hysteroscopic myomectomy (n = 5), a small mural fibroid with a normal cavity, which obviated surgical intervention (n = 4), and endometrial polyps, which altered the treatment plan (n = 1). Sonohysterography suggested the need for an abdominal myomectomy (n = 4) and alerted the surgeon to explore the uterine cavity in three patients.
CONCLUSION: By helping elucidate the cause of bleeding, sonohysterography assisted in determining the therapeutic approach and often reduced the level of surgical intervention or obviated it altogether.
MATERIALS AND METHODS: Sonohysterography was performed in 28 women (aged 29-55 years) in whom transvaginal sonography (TVS) suggested an abnormal endometrial echo (n = 14) or fibroids (n = 14). Its effect on diagnosis and treatment was studied.
RESULTS: In the patients with an abnormal endometrial echo, sonohysterography depicted endometrial polyps (n = 9), intracavitary fibroids (n = 3), placental polyp (n = 1), and a normal cavity (n = 1). Hysteroscopic resection resolved the bleeding in 11 of 14 patients; surgery was obviated in one. In the group with fibroids, sonohysterography depicted small submucous fibroids amenable to hysteroscopic myomectomy (n = 5), a small mural fibroid with a normal cavity, which obviated surgical intervention (n = 4), and endometrial polyps, which altered the treatment plan (n = 1). Sonohysterography suggested the need for an abdominal myomectomy (n = 4) and alerted the surgeon to explore the uterine cavity in three patients.
CONCLUSION: By helping elucidate the cause of bleeding, sonohysterography assisted in determining the therapeutic approach and often reduced the level of surgical intervention or obviated it altogether.