[Ultrasound endometrium diagnosis]

Area of Science:

• Gynecologic imaging
• Diagnostic ultrasound
• Endometrial pathology

Background:

• Ultrasound is increasingly vital in obstetrics and general gynecology.
• Transvaginal sonography (TVS) enhances visualization of delicate structures like the endometrium.
• Diagnostic criteria include endometrial thickness, internal structure, and myometrial involvement.

Purpose of the Study:

• To assess the diagnostic utility of ultrasound, including new technologies like color Doppler and 3D sonography, in evaluating endometrial abnormalities.
• To determine the effectiveness of sonography in differentiating benign conditions from endometrial cancer, particularly in postmenopausal women.

Main Methods:

• Evaluation of endometrial thickness, internal echotexture, and myometrial invasion.
• Assessment of endometrial changes in postmenopausal women with and without hormonal replacement therapy (HRT).
• Comparison of sonographic findings with histopathological results (implicitly, by discussing reduction in currettages).

Main Results:

• In postmenopausal patients without HRT, endometrial thickness alone can diagnose endometrial carcinoma.
• Sonography successfully differentiates endometrial atrophy from cancer in women with postmenopausal bleeding.
• Endometrial thickness measurement is unreliable in patients with HRT; endo/myometrial borderline examination is advantageous.

Conclusions:

• Sonography can significantly reduce the number of diagnostic currettages, as over 70% reveal benign findings.
• Further large-scale prospective studies are needed to fully assess sonography's potential in reducing invasive procedures.
• General screening for endometrial carcinoma using sonography is not currently advocated, except for high-risk patients.