{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:48:19Z","timestamp":1791892099797,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T00:00:00Z","timestamp":1560297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>In women with postmenopausal bleeding, endometrial polyps are a frequent finding and the risk of a focal (pre)malignancy in a polyp is up to 6%. Because of this reported risk, the detection of polyps in these women, preferably by a minimally invasive method, is important. The aim of this systematic review was to assess the accuracy of saline contrast sonohysterography (SCSH) for diagnosis of endometrial polyps in women with postmenopausal bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In August 2018, an electronic search was performed of MEDLINE, EMBASE and Web of Science databases to identify all diagnostic studies in which SCSH was used to detect endometrial polyps in postmenopausal women. Studies were included if SCSH was performed to detect endometrial polyps in women with postmenopausal bleeding and if detection of a polyp on hysteroscopy or diagnosis on histopathology was used as a reference standard. Two reviewers assessed methodological quality using the quality assessment of diagnostic accuracy studies (QUADAS\u20102) tool. Two separate analyses were performed for each reference standard. Pooled sensitivity and specificity were calculated using the hierarchical summary receiver\u2013operating characteristics (HSROC) model and HSROC curves were plotted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After selection and quality assessment, five studies were included. Using \u2018polyps diagnosed with histopathology\u2019 as the reference standard, the pooled sensitivity of SCSH was 86.5% (95% CI, 63.6\u2013100%) and the pooled specificity was 91.1% (95% CI, 63.2\u2013100%). Using \u2018polyps seen on hysteroscopy\u2019 as the reference  standard, the pooled sensitivity of SCSH was 85.1% (95% CI, 66.9\u2013100%) and the pooled specificity was 84.5% (95% CI, 68.1\u2013100%). Excluding the one study that included women in whom the SCSH examination was reported to be suboptimal, the pooled sensitivity increased to 90.7% (95% CI, 72.8\u2013100%) using hysteroscopy as the reference standard. The sensitivity of hysteroscopy to detect polyps, as reported in two studies, was 81\u201398%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Provided that the SCSH examination is of optimal quality, it can be considered as a method to stratify women with postmenopausal bleeding for further diagnostic workup and treatment with hysteroscopy. In women without suspicion of a polypoid lesion on SCSH, and with a benign endometrial sample, expectant management should be considered. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20229","type":"journal-article","created":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T06:36:28Z","timestamp":1548743788000},"page":"28-34","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Diagnostic accuracy of saline contrast sonohysterography in detecting endometrial polyps in women with postmenopausal bleeding: systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4782-1805","authenticated-orcid":false,"given":"A. J.","family":"Vroom","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Maastricht UMC+, GROW School for Oncology and Developmental Biology  Maastricht The Netherlands"},{"name":"Department of Gynecology and Obstetrics Maxima Medisch Centrum  Veldhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Timmermans","sequence":"additional","affiliation":[{"name":"Department of Gynecology Amsterdam Medisch Centrum  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Y.","family":"Bongers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Maastricht UMC+, GROW School for Oncology and Developmental Biology  Maastricht The Netherlands"},{"name":"Department of Gynecology and Obstetrics Maxima Medisch Centrum  Veldhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. R.","family":"van den Heuvel","sequence":"additional","affiliation":[{"name":"Department of Stochastics W&amp;I Technische Universiteit  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. M. A. J.","family":"Geomini","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Maxima Medisch Centrum  Veldhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"van Hanegem","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Maastricht UMC+, GROW School for Oncology and Developmental Biology  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2010.11.010"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2001.801210.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10397-004-0032-1"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14126"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181f74864"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2001.080009856.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70680-4"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1998.11050337.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1076-6332(03)80761-4"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200206000-00010"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.22.4.g02jl21803"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5263"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2003.02472.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2004.029454"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2012.05.004"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/biostatistics\/kxl004"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-005-0016-z"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-010-1604-0"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2001.00472.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1994.04030227.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-009-1150-9"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2015.16.6.1188"},{"key":"e_1_2_6_25_1","first-page":"292","article-title":"Comparison of diagnostic methods for evaluation of postmenopausal bleeding","volume":"35","author":"Nergiz S","year":"2014","journal-title":"Eur J Gynaecol Oncol"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.108332"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2015.12.008"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2004.06.002"},{"key":"e_1_2_6_29_1","unstructured":"MangrulkarR.Patients and Populations. 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