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Diane M Twickler - One of the best experts on this subject based on the ideXlab platform.

  • saline infusion sonography Endometrial sampling compared with Endometrial Biopsy in diagnosing Endometrial pathology
    Obstetrics & Gynecology, 2009
    Co-Authors: Elysia Moschos, Rahella Ashfaq, Donald D Mcintire, Bienviendo Liriano, Diane M Twickler
    Abstract:

    OBJECTIVE: To evaluate prospectively whether salineinfusion sonography Endometrial sampling will improve diagnosis of benign and malignant Endometrial disease compared with blind Endometrial Biopsy in perimenopausal and postmenopausal women with abnormal uterine bleeding. METHODS: After initial assessments and Endometrial biopsies, women aged 40 or older with abnormal uterine bleeding were referred for transvaginal ultrasonography. Patients with abnormal Endometrial evaluations were offered sonohysterography and invited to enter the saline-infusion sonography Endometrial sampling study. Saline-infusion sonography Endometrial sampling was performed at the end of sonohysterography using an Endometrial sampling curette at the sight of the Endometrial abnormality or at a representative site in the Endometrial cavity if the cavity was normal. Histopathologic diagnoses of blind Endometrial Biopsy and saline-infusion sonography Endometrial sampling were compared with final outcomes. Kappa values for the two sampling techniques were calculated for diagnostic accuracy. RESULTS: A total of 88 saline-infusion sonography Endometrial samples were obtained; final outcomes were attained in 80 cases. When comparing saline-infusion sonography Endometrial sampling with final outcomes, saline-infusion sonography Endometrial sampling provided a diagnosis 89% of the time (95% confidence interval [CI] 82–95%) compared with Endometrial Biopsy at 52% (95% CI 42–62%). Forty-five patients with Endometrial biopsies had final outcomes. When comparing Endometrial Biopsy with final outcomes, Endometrial Biopsy underestimated the incidence of pathology, especially when focal lesions and malignancy were present. This difference was statistically significant (P<.005). CONCLUSION: Saline-infusion sonography Endometrial sampling is superior to Endometrial Biopsy in diagnosing Endometrial pathology in perimenopausal and postmenopausal women with abnormal uterine bleeding. (Obstet Gynecol 2009;113:881–7)

  • Saline-infusion sonography Endometrial sampling compared with Endometrial Biopsy in diagnosing Endometrial pathology.
    Obstetrics and gynecology, 2009
    Co-Authors: Elysia Moschos, Rahella Ashfaq, Donald D Mcintire, Bienviendo Liriano, Diane M Twickler
    Abstract:

    OBJECTIVE: To evaluate prospectively whether salineinfusion sonography Endometrial sampling will improve diagnosis of benign and malignant Endometrial disease compared with blind Endometrial Biopsy in perimenopausal and postmenopausal women with abnormal uterine bleeding. METHODS: After initial assessments and Endometrial biopsies, women aged 40 or older with abnormal uterine bleeding were referred for transvaginal ultrasonography. Patients with abnormal Endometrial evaluations were offered sonohysterography and invited to enter the saline-infusion sonography Endometrial sampling study. Saline-infusion sonography Endometrial sampling was performed at the end of sonohysterography using an Endometrial sampling curette at the sight of the Endometrial abnormality or at a representative site in the Endometrial cavity if the cavity was normal. Histopathologic diagnoses of blind Endometrial Biopsy and saline-infusion sonography Endometrial sampling were compared with final outcomes. Kappa values for the two sampling techniques were calculated for diagnostic accuracy. RESULTS: A total of 88 saline-infusion sonography Endometrial samples were obtained; final outcomes were attained in 80 cases. When comparing saline-infusion sonography Endometrial sampling with final outcomes, saline-infusion sonography Endometrial sampling provided a diagnosis 89% of the time (95% confidence interval [CI] 82–95%) compared with Endometrial Biopsy at 52% (95% CI 42–62%). Forty-five patients with Endometrial biopsies had final outcomes. When comparing Endometrial Biopsy with final outcomes, Endometrial Biopsy underestimated the incidence of pathology, especially when focal lesions and malignancy were present. This difference was statistically significant (P

Elysia Moschos - One of the best experts on this subject based on the ideXlab platform.

  • saline infusion sonography Endometrial sampling compared with Endometrial Biopsy in diagnosing Endometrial pathology
    Obstetrics & Gynecology, 2009
    Co-Authors: Elysia Moschos, Rahella Ashfaq, Donald D Mcintire, Bienviendo Liriano, Diane M Twickler
    Abstract:

    OBJECTIVE: To evaluate prospectively whether salineinfusion sonography Endometrial sampling will improve diagnosis of benign and malignant Endometrial disease compared with blind Endometrial Biopsy in perimenopausal and postmenopausal women with abnormal uterine bleeding. METHODS: After initial assessments and Endometrial biopsies, women aged 40 or older with abnormal uterine bleeding were referred for transvaginal ultrasonography. Patients with abnormal Endometrial evaluations were offered sonohysterography and invited to enter the saline-infusion sonography Endometrial sampling study. Saline-infusion sonography Endometrial sampling was performed at the end of sonohysterography using an Endometrial sampling curette at the sight of the Endometrial abnormality or at a representative site in the Endometrial cavity if the cavity was normal. Histopathologic diagnoses of blind Endometrial Biopsy and saline-infusion sonography Endometrial sampling were compared with final outcomes. Kappa values for the two sampling techniques were calculated for diagnostic accuracy. RESULTS: A total of 88 saline-infusion sonography Endometrial samples were obtained; final outcomes were attained in 80 cases. When comparing saline-infusion sonography Endometrial sampling with final outcomes, saline-infusion sonography Endometrial sampling provided a diagnosis 89% of the time (95% confidence interval [CI] 82–95%) compared with Endometrial Biopsy at 52% (95% CI 42–62%). Forty-five patients with Endometrial biopsies had final outcomes. When comparing Endometrial Biopsy with final outcomes, Endometrial Biopsy underestimated the incidence of pathology, especially when focal lesions and malignancy were present. This difference was statistically significant (P<.005). CONCLUSION: Saline-infusion sonography Endometrial sampling is superior to Endometrial Biopsy in diagnosing Endometrial pathology in perimenopausal and postmenopausal women with abnormal uterine bleeding. (Obstet Gynecol 2009;113:881–7)

  • Saline-infusion sonography Endometrial sampling compared with Endometrial Biopsy in diagnosing Endometrial pathology.
    Obstetrics and gynecology, 2009
    Co-Authors: Elysia Moschos, Rahella Ashfaq, Donald D Mcintire, Bienviendo Liriano, Diane M Twickler
    Abstract:

    OBJECTIVE: To evaluate prospectively whether salineinfusion sonography Endometrial sampling will improve diagnosis of benign and malignant Endometrial disease compared with blind Endometrial Biopsy in perimenopausal and postmenopausal women with abnormal uterine bleeding. METHODS: After initial assessments and Endometrial biopsies, women aged 40 or older with abnormal uterine bleeding were referred for transvaginal ultrasonography. Patients with abnormal Endometrial evaluations were offered sonohysterography and invited to enter the saline-infusion sonography Endometrial sampling study. Saline-infusion sonography Endometrial sampling was performed at the end of sonohysterography using an Endometrial sampling curette at the sight of the Endometrial abnormality or at a representative site in the Endometrial cavity if the cavity was normal. Histopathologic diagnoses of blind Endometrial Biopsy and saline-infusion sonography Endometrial sampling were compared with final outcomes. Kappa values for the two sampling techniques were calculated for diagnostic accuracy. RESULTS: A total of 88 saline-infusion sonography Endometrial samples were obtained; final outcomes were attained in 80 cases. When comparing saline-infusion sonography Endometrial sampling with final outcomes, saline-infusion sonography Endometrial sampling provided a diagnosis 89% of the time (95% confidence interval [CI] 82–95%) compared with Endometrial Biopsy at 52% (95% CI 42–62%). Forty-five patients with Endometrial biopsies had final outcomes. When comparing Endometrial Biopsy with final outcomes, Endometrial Biopsy underestimated the incidence of pathology, especially when focal lesions and malignancy were present. This difference was statistically significant (P

James J. Finnerty - One of the best experts on this subject based on the ideXlab platform.

  • the accuracy of Endometrial Biopsy and saline sonohysterography in the determination of the cause of abnormal uterine bleeding
    Obstetrical & Gynecological Survey, 2002
    Co-Authors: Lillian M. Mihm, Valerie A. Quick, Jon Brumfield, Alfred F Connors, James J. Finnerty
    Abstract:

    This study was conducted to investigate the use of Endometrial Biopsy and saline sonohysterography in the evaluation of abnormal uterine bleeding. The results of this combination were compared with pathologic results from hysteroscopy/ dilatation and curettage or hysterectomy. Study participants were women aged 25 to 69 years with persistent uterine bleeding despite at least 3 months of medical treatment. Of 144 women who entered the study, 30 did not complete the protocol, including 1 who could not tolerate the pain associated with saline sonohysterography and 20 who did not have surgical treatment. One hundred thirteen patients had an initial Endometrial Biopsy 6 or 7 weeks before saline sonohysterography. Sonohysterography was performed by placing an inflatable balloon catheter in the cervix. After the balloon was inflated with approximately 2 ml of sterile water, a transvaginal ultrasound probe was inserted into the vagina; the uterine cavity was further distended with 10 to 20 ml of sterile saline solution during the ultrasound examination. Forty-seven women (41.6%) had normal surgical findings (secretory, proliferative, or atrophic endometrium). Sixty-six women had abnormal histopathologic findings, including 37 benign and 2 malignant Endometrial polyps. One malignant and 22 benign submucosal myomas were diagnosed. Four women had Endometrial hyperplasia. Endometrial Biopsy and sonohysterography correctly identified 64 patients with abnormal pathology but failed to diagnosed 2 patients with intrauterine pathology; it did predict negative findings in 2 women who were positive in the surgical specimen. The combination also overdiagnosed 14 women as positive who had negative surgical specimens. Thirty-three patients were correctly identified as negative. The sensitivity and specificity of Endometrial Biopsy and saline sonohysterography were 0.970 (0.886-0.995) and 0.702 (0.550-0.822), respectively. The positive and negative predictive values were 0.821 (0.714-0.895) and 0.943 (0.796-0.990), respectively.

  • the accuracy of Endometrial Biopsy and saline sonohysterography in the determination of the cause of abnormal uterine bleeding
    American Journal of Obstetrics and Gynecology, 2002
    Co-Authors: Lillian M. Mihm, Valerie A. Quick, Jon Brumfield, Alfred F Connors, James J. Finnerty
    Abstract:

    Abstract Objective: The purpose of this study was to determine the accuracy of outpatient Endometrial Biopsy and saline sonohysterography for the evaluation of abnormal uterine bleeding. Study Design: Eligible participants included women aged 25 to 69 years who complained of persistent uterine bleeding, despite medical treatment. One hundred forty-four patients consented and were followed up prospectively: 1 patient did not successfully complete a saline sonohysterography because of discomfort, 143 patients underwent an Endometrial Biopsy and saline sonohysterography as outpatients, 113 patients underwent a definitive surgical intervention (hysteroscopy/dilatation and curettage or hysterectomy), 20 patients did not complete a gold standard measure, and 10 patients were lost to follow-up. Results: The combination of Endometrial Biopsy and saline sonohysterography for the 113 patients who completed the study had a sensitivity and specificity for the detection of abnormal pathologic features of 97.0% (95% CI, 88.6-99.5) and 70.2% (95% CI, 55.0-82.2) and a positive and negative predictive value of 82.1% (95% CI, 71.4-89.5) and 94.3% (95% CI, 79.6-99.0) compared with hysteroscopy/curettage or hysterectomy. Conclusion: The high sensitivity and high negative predictive value of saline sonohysterography combined with Endometrial Biopsy make this technique useful for the evaluation of abnormal uterine bleeding. It may allow some patients to avoid more invasive operative procedures; however, it is important to recognize the limitations in the predictive value of this diagnostic modality. (Am J Obstet Gynecol 2002;186:858-60.)

  • The accuracy of Endometrial Biopsy and saline sonohysterography in determining the etiology of abnormal uterine bleeding
    Obstetrics & Gynecology, 2001
    Co-Authors: Lillian M. Mihm, James J. Finnerty, Amir A. Jazaeri, Valerie A. Quick, Jon Brumfield, Alfred L. Connors
    Abstract:

    Abstract Objective: To compare the results of Endometrial Biopsy and saline sonohysterography to that of D & C/hysteroscopy or definitive surgery in the evaluation of abnormal uterine bleeding. Methods: The study protocol was approved by the Human Investigation Committee. The patient population studied consisted of women presenting to outpatient services complaining of a history of abnormal uterine bleeding who had failed conservative medical management. The study consisted of two arms with a combined total of 120 patients. The prospective arm included 91 patients who underwent Endometrial Biopsy and saline sonohysterography as outpatients before being evaluated by a definitive surgical procedure such as D & C/hysteroscopy with or without thermal balloon ablation or hysterectomy. The retrospective group included 41 patients who before the initiation of this study had Endometrial biopsies and saline sonohysterography performed with subsequent definitive surgical procedures. These charts were reviewed retrospectively and included in the results as a separate group. All saline sonohysterographies and procedures were performed under supervision of the attending staff. Results: The combination of Endometrial Biopsy and saline sonohysterography had a sensitivity and specificity of 96.2% and 65.7%, respectively. The positive predictive value of a saline sonohysterography study showing an Endometrial polyp, submucous myoma, or irregular Endometrial contour was 80.6%. A normal saline sonohysterography had a negative predictive value of 92.0%. Conclusions: Endometrial Biopsy and saline sonohysterography are useful for the evaluation of abnormal uterine bleeding; however, it is important to recognize the limitations in the predictive value of this diagnostic modality.

Lillian M. Mihm - One of the best experts on this subject based on the ideXlab platform.

  • the accuracy of Endometrial Biopsy and saline sonohysterography in the determination of the cause of abnormal uterine bleeding
    Obstetrical & Gynecological Survey, 2002
    Co-Authors: Lillian M. Mihm, Valerie A. Quick, Jon Brumfield, Alfred F Connors, James J. Finnerty
    Abstract:

    This study was conducted to investigate the use of Endometrial Biopsy and saline sonohysterography in the evaluation of abnormal uterine bleeding. The results of this combination were compared with pathologic results from hysteroscopy/ dilatation and curettage or hysterectomy. Study participants were women aged 25 to 69 years with persistent uterine bleeding despite at least 3 months of medical treatment. Of 144 women who entered the study, 30 did not complete the protocol, including 1 who could not tolerate the pain associated with saline sonohysterography and 20 who did not have surgical treatment. One hundred thirteen patients had an initial Endometrial Biopsy 6 or 7 weeks before saline sonohysterography. Sonohysterography was performed by placing an inflatable balloon catheter in the cervix. After the balloon was inflated with approximately 2 ml of sterile water, a transvaginal ultrasound probe was inserted into the vagina; the uterine cavity was further distended with 10 to 20 ml of sterile saline solution during the ultrasound examination. Forty-seven women (41.6%) had normal surgical findings (secretory, proliferative, or atrophic endometrium). Sixty-six women had abnormal histopathologic findings, including 37 benign and 2 malignant Endometrial polyps. One malignant and 22 benign submucosal myomas were diagnosed. Four women had Endometrial hyperplasia. Endometrial Biopsy and sonohysterography correctly identified 64 patients with abnormal pathology but failed to diagnosed 2 patients with intrauterine pathology; it did predict negative findings in 2 women who were positive in the surgical specimen. The combination also overdiagnosed 14 women as positive who had negative surgical specimens. Thirty-three patients were correctly identified as negative. The sensitivity and specificity of Endometrial Biopsy and saline sonohysterography were 0.970 (0.886-0.995) and 0.702 (0.550-0.822), respectively. The positive and negative predictive values were 0.821 (0.714-0.895) and 0.943 (0.796-0.990), respectively.

  • the accuracy of Endometrial Biopsy and saline sonohysterography in the determination of the cause of abnormal uterine bleeding
    American Journal of Obstetrics and Gynecology, 2002
    Co-Authors: Lillian M. Mihm, Valerie A. Quick, Jon Brumfield, Alfred F Connors, James J. Finnerty
    Abstract:

    Abstract Objective: The purpose of this study was to determine the accuracy of outpatient Endometrial Biopsy and saline sonohysterography for the evaluation of abnormal uterine bleeding. Study Design: Eligible participants included women aged 25 to 69 years who complained of persistent uterine bleeding, despite medical treatment. One hundred forty-four patients consented and were followed up prospectively: 1 patient did not successfully complete a saline sonohysterography because of discomfort, 143 patients underwent an Endometrial Biopsy and saline sonohysterography as outpatients, 113 patients underwent a definitive surgical intervention (hysteroscopy/dilatation and curettage or hysterectomy), 20 patients did not complete a gold standard measure, and 10 patients were lost to follow-up. Results: The combination of Endometrial Biopsy and saline sonohysterography for the 113 patients who completed the study had a sensitivity and specificity for the detection of abnormal pathologic features of 97.0% (95% CI, 88.6-99.5) and 70.2% (95% CI, 55.0-82.2) and a positive and negative predictive value of 82.1% (95% CI, 71.4-89.5) and 94.3% (95% CI, 79.6-99.0) compared with hysteroscopy/curettage or hysterectomy. Conclusion: The high sensitivity and high negative predictive value of saline sonohysterography combined with Endometrial Biopsy make this technique useful for the evaluation of abnormal uterine bleeding. It may allow some patients to avoid more invasive operative procedures; however, it is important to recognize the limitations in the predictive value of this diagnostic modality. (Am J Obstet Gynecol 2002;186:858-60.)

  • The accuracy of Endometrial Biopsy and saline sonohysterography in determining the etiology of abnormal uterine bleeding
    Obstetrics & Gynecology, 2001
    Co-Authors: Lillian M. Mihm, James J. Finnerty, Amir A. Jazaeri, Valerie A. Quick, Jon Brumfield, Alfred L. Connors
    Abstract:

    Abstract Objective: To compare the results of Endometrial Biopsy and saline sonohysterography to that of D & C/hysteroscopy or definitive surgery in the evaluation of abnormal uterine bleeding. Methods: The study protocol was approved by the Human Investigation Committee. The patient population studied consisted of women presenting to outpatient services complaining of a history of abnormal uterine bleeding who had failed conservative medical management. The study consisted of two arms with a combined total of 120 patients. The prospective arm included 91 patients who underwent Endometrial Biopsy and saline sonohysterography as outpatients before being evaluated by a definitive surgical procedure such as D & C/hysteroscopy with or without thermal balloon ablation or hysterectomy. The retrospective group included 41 patients who before the initiation of this study had Endometrial biopsies and saline sonohysterography performed with subsequent definitive surgical procedures. These charts were reviewed retrospectively and included in the results as a separate group. All saline sonohysterographies and procedures were performed under supervision of the attending staff. Results: The combination of Endometrial Biopsy and saline sonohysterography had a sensitivity and specificity of 96.2% and 65.7%, respectively. The positive predictive value of a saline sonohysterography study showing an Endometrial polyp, submucous myoma, or irregular Endometrial contour was 80.6%. A normal saline sonohysterography had a negative predictive value of 92.0%. Conclusions: Endometrial Biopsy and saline sonohysterography are useful for the evaluation of abnormal uterine bleeding; however, it is important to recognize the limitations in the predictive value of this diagnostic modality.

Bienviendo Liriano - One of the best experts on this subject based on the ideXlab platform.

  • saline infusion sonography Endometrial sampling compared with Endometrial Biopsy in diagnosing Endometrial pathology
    Obstetrics & Gynecology, 2009
    Co-Authors: Elysia Moschos, Rahella Ashfaq, Donald D Mcintire, Bienviendo Liriano, Diane M Twickler
    Abstract:

    OBJECTIVE: To evaluate prospectively whether salineinfusion sonography Endometrial sampling will improve diagnosis of benign and malignant Endometrial disease compared with blind Endometrial Biopsy in perimenopausal and postmenopausal women with abnormal uterine bleeding. METHODS: After initial assessments and Endometrial biopsies, women aged 40 or older with abnormal uterine bleeding were referred for transvaginal ultrasonography. Patients with abnormal Endometrial evaluations were offered sonohysterography and invited to enter the saline-infusion sonography Endometrial sampling study. Saline-infusion sonography Endometrial sampling was performed at the end of sonohysterography using an Endometrial sampling curette at the sight of the Endometrial abnormality or at a representative site in the Endometrial cavity if the cavity was normal. Histopathologic diagnoses of blind Endometrial Biopsy and saline-infusion sonography Endometrial sampling were compared with final outcomes. Kappa values for the two sampling techniques were calculated for diagnostic accuracy. RESULTS: A total of 88 saline-infusion sonography Endometrial samples were obtained; final outcomes were attained in 80 cases. When comparing saline-infusion sonography Endometrial sampling with final outcomes, saline-infusion sonography Endometrial sampling provided a diagnosis 89% of the time (95% confidence interval [CI] 82–95%) compared with Endometrial Biopsy at 52% (95% CI 42–62%). Forty-five patients with Endometrial biopsies had final outcomes. When comparing Endometrial Biopsy with final outcomes, Endometrial Biopsy underestimated the incidence of pathology, especially when focal lesions and malignancy were present. This difference was statistically significant (P<.005). CONCLUSION: Saline-infusion sonography Endometrial sampling is superior to Endometrial Biopsy in diagnosing Endometrial pathology in perimenopausal and postmenopausal women with abnormal uterine bleeding. (Obstet Gynecol 2009;113:881–7)

  • Saline-infusion sonography Endometrial sampling compared with Endometrial Biopsy in diagnosing Endometrial pathology.
    Obstetrics and gynecology, 2009
    Co-Authors: Elysia Moschos, Rahella Ashfaq, Donald D Mcintire, Bienviendo Liriano, Diane M Twickler
    Abstract:

    OBJECTIVE: To evaluate prospectively whether salineinfusion sonography Endometrial sampling will improve diagnosis of benign and malignant Endometrial disease compared with blind Endometrial Biopsy in perimenopausal and postmenopausal women with abnormal uterine bleeding. METHODS: After initial assessments and Endometrial biopsies, women aged 40 or older with abnormal uterine bleeding were referred for transvaginal ultrasonography. Patients with abnormal Endometrial evaluations were offered sonohysterography and invited to enter the saline-infusion sonography Endometrial sampling study. Saline-infusion sonography Endometrial sampling was performed at the end of sonohysterography using an Endometrial sampling curette at the sight of the Endometrial abnormality or at a representative site in the Endometrial cavity if the cavity was normal. Histopathologic diagnoses of blind Endometrial Biopsy and saline-infusion sonography Endometrial sampling were compared with final outcomes. Kappa values for the two sampling techniques were calculated for diagnostic accuracy. RESULTS: A total of 88 saline-infusion sonography Endometrial samples were obtained; final outcomes were attained in 80 cases. When comparing saline-infusion sonography Endometrial sampling with final outcomes, saline-infusion sonography Endometrial sampling provided a diagnosis 89% of the time (95% confidence interval [CI] 82–95%) compared with Endometrial Biopsy at 52% (95% CI 42–62%). Forty-five patients with Endometrial biopsies had final outcomes. When comparing Endometrial Biopsy with final outcomes, Endometrial Biopsy underestimated the incidence of pathology, especially when focal lesions and malignancy were present. This difference was statistically significant (P