[Transvaginal ultrasonic assessment of the endometrium in menopause]

Early detection of endometrial cancer is hardly possible. In nearly 90% of all cases irregular vaginal bleeding is the first clinical sign of this disease. New ultrasound technique, small scanner probes and especially higher ultrasound frequencies rendered a better resolving power and higher quality medical imaging. Hence, now the examination of the organs in the female pelvis is very exact using vaginal sonography (VS). A clinical study was performed to examine the relevance of VS assessing changes and details of the endometrium. In particular, the sonographical criteria of early endometrial cancer should be defined. In 137 postmenopausal women VS was performed after irregular vaginal bleeding and prior to D&C. All findings were described concerning alteration in echogenicity and thickness of the endometrium. Only one case of 37 histological confirmed endometrial cancers among the study group was not detected by VS prior to curettage. Therefore 0.7% of the sonographical findings showed a false negative result and 6.6% were false positive in comparison to the histological outcome. VS seems to be a relatively reliable technique in assessing the endometrium. In conclusion VS could be a useful additional method to detect hyperplasia or malignant disorders of the endometrium.