Sensibilidad y especificidad diagnóstica: histeroscopia versus ecografía transvaginal en el sangrado uterino anormal. Revisión sistemática

Abstract

Diagnosing abnormal uterine bleeding (AUB) requires precise techniques to clarify its cause. This systematic review compares transvaginal ultrasound and hysteroscopy methods in terms of sensitivity and specificity for the overall diagnosis of abnormal uterine bleeding of structural origin. The methodology followed the PRISMA model, including randomized clinical trials and observational studies published in English or Spanish. Results: The studies revealed that hysteroscopy had a notable sensitivity of 82.35% but limited specificity (47.06%). In contrast, ultrasound demonstrated higher specificity at 83.3% but lower sensitivity (42.67%). Regarding positive predictive value, transvaginal ultrasound was superior with 71.23% compared to hysteroscopy with 60.87%, while the opposite was observed for the negative predictive value. Likelihood ratios (LR) indicated favorable values for hysteroscopy. Conclusion: Although both methods have advantages, hysteroscopy is more suitable for diagnosing AUB. The choice of technique depends on clinical factors, available resources, and patient-specific characteristics. Keywords: hysteroscopy, transvaginal ultrasound, sensitivity, specificity, predictive value