Imaging techniques for evaluation of the uterine cavity and endometrium in premenopausal XXXX before minimally invasive surgery.

@entity1 @entity1127 @entity548 @entity1373 @entity854 @entity1868
A literature review compared the diagnostic effectiveness and accuracy of transvaginal sonography (TVS) hysterosonographic examination (HSE), hysteroscopy (HY), and magnetic resonance imaging (MRI) in abnormalities of the uterine cavity and endometrium in premenopausal @entity1 referred to surgery and @entity1 with abnormal uterine @entity548 . The studies varied much in terms of @entity1 selection, number of observers, blinding and experience of observers, and @entity854 criteria. The diagnostic effectiveness of the techniques reviewed varied: TVS only reached intermediate quality levels as a diagnostic tool for exclusion of uterine cavity abnormalities and no data support that MRI, TVS, HY, or HSE may exclude @entity1373 without concomitant endometrial sampling. HY and HSE were equally effective and apparently outperformed TVS, especially for identification of @entity1127 . However, all techniques carried a significant number of false positive results. MRI does not satisfy current diagnostic demands for detection of endometrial abnormalities, but it is sufficiently accurate for @entity1868 ( @entity1868 ) evaluation. TVS, HSE, and HY carry much observer variation as opposed to MRI. In experienced hands TVS should be a first choice modality, but its precision and consistency fall short of current needs and it should therefore be supplemented by other techniques. HSE or HY performed by experienced clinicians should be used as supplements to TVS for exclusion of @entity1127 . MRI can be recommended as the first choice modality for exact evaluation of @entity1868 uterine in-growth before advanced minimal invasive treatment of @entity1868 . Clinicians should be aware that modern imaging techniques may yield highly idiosyncratic results when used by inexperienced staff, and efforts should be made to reduce such observer variation. TARGET AUDIENCE: Obstetricians _ Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader will be able to describe the diagnostic strengths and weaknesses of the various diagnostic tests in the evaluation of abnormal uterine @entity548 and to compare the accuracy of each test to the others.
