Application of transvaginal sonography and hysteroscopy for the diagnosis of abnormal uterine bleeding in perimenopausal women.

Objective To investigate the clinical value of transvaginal sonography and hysteroscopy for the diagnosis of abnormal uterine bleeding in perimenopausal women.Method Data from 180 patients were collected and compiled as thegold standard for comparing the sensitivity and positive predictive value of transvaginal sonography and hysteroscopy.Results The sensitivity of hysteroscopy was significantly higher than that of transvaginal sonography(97.7%,92.9%,95.6% vs 77.3%,57.1%,82.2%)in diagnosis of endometrial hyperplasia,endometrial carcinoma and non-space occupying lesions of endometrium(normal endometrium,endometritis and atrophic endometrium).The positive predictive value of hysteroscopy was significantly higher than that of transvaginal sonography(96.2%,93.5% vs 79.7%,75.6%)in diagnosis of endometrial ployp and endometrial hyperplasia.Conclusions Transvaginal ultrasound can be used as a conventional method for clinical screening in perimenopausal women.Hysteroscopy can be used in the finding of intrauterine abnormalities,especially in the patients with unknown situation or after transvaginal ultrasound examination.