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[Transvaginal sonography of the postmenopausal endometrium]
A Curcić1, D Segedi, Z Belopavlović
1Klinika za ginekologiju i akuserstvo, Novi Sad.
Medicinski Pregled
|August 23, 2000
Summary
Transvaginal ultrasonography effectively detects endometrial pathology in postmenopausal women. A 3 mm endometrial thickness or less safely predicts atrophy, while greater thickness warrants further investigation to rule out serious conditions.
Area of Science:
- Gynecology
- Diagnostic Imaging
Background:
- Postmenopausal uterine bleeding often necessitates invasive diagnostic procedures.
- Endometrial pathology requires accurate and timely diagnosis.
Purpose of the Study:
- To evaluate ultrasonography's efficacy in detecting endometrial pathology in postmenopausal women.
- To determine if increased ultrasonography use can reduce diagnostic curettages.
Main Methods:
- Prospective study of postmenopausal women with uterine bleeding.
- Transvaginal ultrasonography (5 MHz) followed by fractional curettage and histopathology.
- Sensitivity and specificity calculated for ultrasonographic findings.
Main Results:
- Ultrasonography visualized endometrium in all 35 cases.
- Prevalence of findings: atrophy (17.14%), polyp (11.43%), hyperplasia (22.86%), adenocarcinoma (42.86%), sarcoma (5.71%).
- Sensitivity 93.10%, specificity 66.66% with a 3 mm cutoff; higher cutoffs improved sensitivity but reduced specificity.
Conclusions:
- Transvaginal sonography is an efficient, non-invasive tool for early detection of endometrial pathology.
- Endometrial thickness >3 mm is a significant indicator for further investigation.
- Ultrasonography aids in predicting endometrial atrophy but cannot definitively differentiate benign from malignant conditions without histopathology.