The role of elastography in the differential diagnosis of endometrial pathologies--preliminary report

The aim of the study was to prove the possibility of elastography application in the assessment of the indications for dilatation and curettage (D&C) of the uterine cavity in patients with wide endometrium found in transvaginal ultrasound examination.

Analyzed group consisted of 25 perimenopausal women admitted for D&C due to the suspicion of endometrial hypertrophy. In all the patients transvaginal ultrasound examination in B-mode and elastography by the use of ElastoScan software were performed. Endometrium was described by Elastography Index (EI) presented in previous publications. The results were compared to the pathological results from D&C.

Statistical analysis revealed significant difference of elastography image of endometrium described by EI between patients with normal or atrophic endometrium confirmed by pathological examination and women with abnormal findings--endometrial cancer hypertrophy or polyp (chi2 Pearson test; p=0.00005). EI in the group with normal endometrium was 0 or 1 point and in the group with endometrial pathology was from 2 to 4 points. No patient with EI for endometrium above 1 point had normal or atrophic endometrium and no woman with EI 0 or 1 had any pathologic finding.

Elastography as a new diagnostic technique in gynecology seems to be a valuable tool differentiating endometrial pathologies from normal or atrophic endometrium in perimenopausal women with endometrium thickness above 5 mm in transvaginal ultrasound examination.