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Rev Bras Ginecol Obstet 2016; 38(10): 506-511
DOI: 10.1055/s-0036-1593774
Original Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Accuracy of Transvaginal Ultrasonography, Hysteroscopy and Uterine Curettage in Evaluating Endometrial Pathologies

Acurácia da ultrassonografia transvaginal, histeroscopia e curetagem uterina na avaliação de patologias endometriais
Miriam da Silva Wanderley
1   Gynecology and Obstetrics, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
,
Miriam Monteiro Álvares
2   Service of Gynecology and Obstetrics, Hospital Universitário de Brasília (HUB), Brasília, Brazil
,
Maria de Fátima Brito Vogt
1   Gynecology and Obstetrics, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
,
Lizandra Moura Paravidine Sazaki
2   Service of Gynecology and Obstetrics, Hospital Universitário de Brasília (HUB), Brasília, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

11. Mai 2016

02. September 2016

Publikationsdatum:
21. Oktober 2016 (online)

   Lizenzen und Reprints

Abstract

Objective To evaluate the accuracy of transvaginal ultrasonography, hysteroscopy and uterine curettage in the diagnosis of endometrial polyp, submucous myoma and endometrial hyperplasia, using as gold standard the histopathological analysis of biopsy samples obtained during hysteroscopy or uterine curettage.

Methods Cross-sectional study performed at the Hospital Universitário de Brasília (HUB). Data were obtained from the charts of patients submitted to hysteroscopy or uterine curettage in the period from July 2007 to July 2012.

Results One-hundred and ninety-one patients were evaluated, 134 of whom underwent hysteroscopy, and 57, uterine curettage. Hysteroscopy revealed a diagnostic accuracy higher than 90% for all the diseases evaluated, while transvaginal ultrasonography showed an accuracy of 65.9% for polyps, 78.1% for myoma and 63.2% for endometrial hyperplasia. Within the 57 patients submitted to uterine curettage, there was an accuracy of 56% for polyps and 54.6% for endometrial hyperplasia.

Conclusion Ideally, after initial investigation with transvaginal ultrasonography, guided biopsy of the lesion should be performed by hysteroscopy, whenever necessary, in order to improve the diagnostic accuracy and subsequent clinical management.

Resumo

Objetivo avaliar a acurácia da ultrassonografia transvaginal, da histeroscopia e da curetagem uterina no diagnóstico de pólipo endometrial, mioma submucoso e hiperplasia de endométrio, utilizando como padrão-ouro a análise histopatológica de amostras obtidas por biópsia realizada durante a histeroscopia ou a curetagem.

Métodos estudo transversal realizado no Hospital Universitário de Brasília (HUB), cujas informações foram obtidas nos prontuários das pacientes que foram submetidas à histeroscopia ou curetagem uterina no período de julho de 2007 a julho de 2012.

Resultados Foram avaliadas 191 pacientes, sendo que 134 foram submetidas à histeroscopia e 57 à curetagem uterina. Observou-se acurácia diagnóstica maior que 90% para todas as patologias avaliadas por histeroscopia, enquanto que por ultrassonografia transvaginal observou-se acurácia de 65,9% para pólipo, 78,1% para mioma e 63,2% para hiperplasia endometrial. Nas 57 pacientes submetidas a curetagem uterina, observou-se acurácia de 56% para pólipo e de 54,6% para hiperplasia endometrial.

Conclusão Idealmente, após a investigação inicial com ultrassonografia transvaginal, deveria, sempre que necessário, ser realizada histeroscopia com biópsia guiada da lesão, o que melhoraria a acurácia diagnóstica e posterior conduta clínica.

Keywords

endometrial polyp - submucous myoma - endometrial hyperplasia - transvaginal ultrasonography - hysteroscopy - uterine curettage - accuracy

Palavras-chave

pólipo endometrial - mioma submucoso - hiperplasia endometrial - ultrassonografia transvaginal - histeroscopia - curetagem uterina - acurácia
 

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