Vaginosonography and its diagnostic value in patients with postmenopausal bleeding

Using a transvaginal 240 degrees "panorama" sector scanner (5.0 MHz) we performed a sonographic study in 106 women with postmenopausal bleeding before they had a diagnostic dilatation and curettage. Sonographic findings were classified as (1) normal thin endometrial echo, (2) pathologically thickened echo (i.e. more than 1/3 of the a.-p. diameter of the myometrial wall) and (3) spherical echoes representing myomas. We also looked carefully at the borders of the endometrium. 21 cases could not be included because of no histological specimen was available or because the vagina was too narrow for insertion of the probe. The histological and sonographic results were compared. Of 39 women with pathologically thickened endometrial echoes 12 had invasive carcinomas, 9 hyperplastic endometrium, 16 polyps and 2 had normal atrophic endometrium. In the 46 women with normal endometrial echoes 1 had a carcinoma (confined to the mucosa and obscured by a myoma), 1 had hyperplastic endometrium, 4 had small polyps (size below 5 mm) and 40 had normal atrophic endometrium.