[COMPARISON OF ULTRASOUND INVESTIGATION METHODS IN POSTMENOPAUSE]

The aim of the study is to improve the diagnostic approach in assessing the state of the endometrium with the help of ultrasonic endometrial diagnostics in accordance with the IETА criteria in combination with three-dimensional Doppler indices, calculating the volume of the endometrium, and the 3D reconstruction in postmenopausal women. 167 postmenopausal women underwent a 2D pelvic ultrasound examination and a combined three-dimensional complex pelvic ultrasound examination that included calculation of the volume of the endometrium, three-dimensional dopplerometric indices (vascularization index, blood flow index and vascularization ratio), and 3D-reconstruction mode. In the second stage, the patients underwent hysteroscopy/endometrial bipyroscopy with morphological evaluation of tissue samples, which retrospectively performed analysis of echographic and dopplerometric criteria in patients with benign changes in the endometrium and their comparison with atrophic endometrium. In addition, a comparative analysis of the 2D ultrasound method and its combination with a complex 3D study was carried out. Most of the echographic criteria between the groups of hyperproliferative pathology and endometrial atrophy had statistical differences, but there were no significant differences in comparison with the group of synechia of the uterine cavity and cystic atrophy. While the analysis of Dopplerometric criteria both in the two-dimensional mode and with its combination with trimer techniques demonstrated a statistical difference between the indices in the groups of the endometrial hyperpliphyral pathology and the endometrium atrophy, including its cystic form, and also the synechia of the uterine cavity. Based on the results of the comparative analysis of the ultrasound modes, the combination of 2D study with a complex 3D study increases the sensitivity of the method by 12%, and the specificity by 13%. Three-dimensional echography with the determination of dopplerometric indices and volume of endometrium and 3D reconstruction is highly accurate in the diagnosis of endometrial pathology, its wide practical application at the preoperative stage will allow to improve the quality of diagnostics and to formulate clear criteria for hysteroscopy in postmenopausal women. The results of the study show that the thickness of the endometrium is not an absolute criterion in determining the pathology of the endometrium. The main criterion in the diagnosis of hyperproliferative changes in the endometrium in postmenopause is the presence in it of vascularization.