| Objective:To investigate the diagnostic value of transvaginal ultrasound (TVS), hysterosalpingography (HSG), saline
intrauterine sonohysterograph (SIS) alone and combination of three methods for endometrial polyps (EP) of patients with infertility.Methods:206 cases of patients with infertility inspected by hysteroscopy combined with curettage or pathological examination were
selected as the research objective, the screening results of different methods for EP were retrospectively analyzed, and the authenticity,
reliability and prediction of different methods were evaluated.Results:60 cases of EP were diagnosed in 206 cases of patients with
infertility, the positive rate was 29.1%. In the three kinds of examination methods, the sensitivity of TVS was the highest (70%) with
highest misdiagnosis rate (26.7%), the specificity (73.3%) was the lowest with minimum rate of missed diagnosis (30%), and the correct
diagnosis index of TVS was the highest (43.3%) with the minimumnegative likelihood ratio (0.409) and highest negative predictive value
(85.6%). The sensitivity of SIS detection was minimum (38.7%) with highest rate of missed diagnosis (61.3%), however, the specificity
(93.3%) was highest with the lowest (6.7%) misdiagnosis rate, maximum (4.284) positive likelihood ratio and the maximum (66.6%)
positive predictive, the correct diagnosis of SIS was the lowest (32%). The above indexes of HSG examination were between TVS and
SIS. The coincidence rate of TVS and SIS with the gold standard was low, and Kappa values were less than 0.4. The coincidence rate
(86.2%) of HSG was the highest with 0.647 Kappa value. While three kinds of test combined together, sensitivity of results was 89.3%
with 10.7%missed diagnosis rate, the specificity was 91.4%with 8.6%misdiagnosis, the correct diagnosis index was 80.7%, the positive
likelihood ratio was 10.384 with 0.117 negative likelihood ratio, the coincidence rate was 89.3%and Kappa value was 0.792, the positive
predictive value was 83.3%with 94.6% negative predictive value.Conclusion:Using TVS, HSG or SIS alone for the diagnosis of EP in patients with infertility, the sensitivities were all low with high rates of missed diagnosis, and consistency with the gold standard were
poor, but the authenticity, reliability and prediction values of combination of three methods for the diagnosis of EP, were better. |
