Diagnostic value of hysterosalpingography in the detection of intrauterine abnormalities: a comparison with hysteroscopy.

OBJECTIVE The purpose of this study was to evaluate the diagnostic accuracy of hysterosalpingography (HSG) in comparison with hysteroscopy in the detection of intrauterine abnormality in infertile patients. MATERIALS AND METHODS Seventy-eight patients being investigated for infertility and undergoing HSG and hysteroscopy were studied retrospectively. Radiologic findings on HSG, including single or multiple filling defects and uterine wall irregularities, were evaluated and compared with hysteroscopic findings, which were considered the reference standard. RESULTS HSG showed a sensitivity of 81.2% compared with that of hysteroscopy and a specificity of 80.4%, with a positive predictive value of 63.4% and a negative predictive value of 83.7%. HSG also had a false-negative rate of 90% and a false-positive rate of 21.8%. Overall agreement between the two procedures was 73%. CONCLUSION HSG is still a useful screening test for the evaluation of the uterine cavity in the study of primary or secondary infertility. In addition, HSG provides information concerning the assessment of tubal morphology and patency. We believe that these two procedures are complementary in the evaluation of the uterine cavity.