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Sonohysterography-Guided Biopsy of Focal Endometrial Abnormalities: Technical Feasibility and Diagnostic Accuracy |
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Eun Ju Lee, M.D. Jun Man Kim, M.D., Hee Jae Joo, M.D.*, Mi Ran Kim, M.D.**, Kyung Joo Hwang, M.D.** |
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Department of Diagnostic Radiology, Ajou University School of Medicine *Department of Pathology, Ajou University School of Medicine**Department of Obstetrics and Gynecology, Ajou University School of Medicine |
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PURPOSE : To assess the feasibility and diagnostic accuracy of a sononohysterography-guided biopsy in an evaluation
of focal endometrial lesions.
MATERIALS and METHODS : Sixty-five consecutive patients with focal endometrial lesions detected on baseline sonohysterography
were enrolled prospectively. The biopsy was performed under real-time sonohysterography
guidance, using a 3.1 mm Pipelle endometrial sampler as the primary biopsy device. The feasibility was evaluated
from the technical success rates and the number of “diagnostic” specimen for the histological diagnosis. The
diagnostic accuracy was assessed by comparing the biopsy results with the final pathological diagnosis obtained
by the surgical procedure.
RESULTS : Sonohysterography-guided biopsy was performed successfully in 59(90.8%) out of 65 patients. The reasons
for failure in 6 patients were a failure to pass through the cervix (n=3); failure to target a focal lesion (n=2);
and inadequate uterine distension (n=1). The biopsy specimen was “diagnostic” in 49 (83.1%) out of 50 patients,
and “non-diagnostic” in 10 patients with insufficient tissue (n=6) and indeterminate cellular features for a
histological diagnosis (n=4). The cytology results of the sonohysterographically-guided biopsy correlated well
with the pathological diagnosis in 35 (92.1%) out of 38 patients who underwent subsequent surgical procedures.
CONCLUSION : Sonohysterography-guided biopsy is technically feasible and can be an accurate method for diagnosing
focal endometrial lesions. It could be considered to be a reliable office triage as an alternative to hysteroscopic
biopsy in patients with focal endometrial abnormalities. |
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Keyword : Uterus, endometrium Uterus, US Biopsies, technology Ultrasound(US), guidance |
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pdf파일 : 25-31이은주.pdf
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