Does Transvaginal Ultrasonography Have Good Diagnostic Value in Endometrial Pathology?

In: IIUM Medical Journal Malaysia · 2011 · vol. 10(2) · doi:10.31436/imjm.v10i2.677 · W2625300917
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Transvaginal ultrasonography's diagnostic value for endometrial pathology in post-menopausal bleeding was evaluated, finding an endometrial thickness of less than 6 mm unlikely to indicate pathology.

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This study evaluated whether endometrial thickness measured by transvaginal ultrasonography (TVS) has diagnostic value for endometrial pathology in 60 post-menopausal women with uterine bleeding, with TVS followed by dilatation and curettage within one day. Endometrial atrophy was classified as normal, while hyperplasia, endometrial polyps, and carcinoma were classified as abnormal. TVS for uterine pathology showed sensitivity 83.3%, specificity 86.7%, and predictive values around 84–86%, and an endometrial thickness less than 6 mm was reported as unlikely to indicate endometrial pathology. The paper’s limitation is that the study population is relatively small and confined to post-menopausal bleeding, limiting generalizability beyond that setting. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Introduction: Endometrial biopsy is usually considered unnecessary in post-menopausal uterine bleeding when the endometrial thickness (ET) is less than 5 mm because the risk of endometrial hyperplasia or cancer is low. However, there is still much controversy from this as some believe that the diagnostic value of ET in diagnosis of endometrial pathology (EP) in postmenopausal bleeding is necessary. In this study, the diagnostic value of ET for diagnosis of EP in post-menopausal bleeding was evaluated. Materials and methods: Sixty post-menopausal women with uterine bleeding were evaluated. Transvaginal ultrasonography (TVS) was used for measurement of ET followed by dilatation and curettage in a one-day interval. According to the EP, patients were divided in two groups, normal and abnormal. Endometrial atrophy was considered as normal and hyperplasia, polyps and carcinoma was considered as abnormal. Results: Twenty nine cases had ET more than 6 mm, among them, 25 cases had abnormal pathology (hyperplasia, polyp, cancer) and 4 cases were normal (atrophy). Thirty-one patients had ET equal or less than 6mm, among them, 26 cases were normal (atrophy) and 5 cases had abnormal pathology. The sensitivity, specifi ty, positive and negative predictive values of TVS in the diagnosis of uterine pathology were 83.3%, 86.7%, 86.2%, 83.9% respectively. Conclusion: We suggest that an ET of less than 6 mm in TVS is unlikely to indicate EP in post-menopausal women with uterine bleeding.
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Does Transvaginal Ultrasonography Have Good Diagnostic Value in Endometrial Pathology? DOI: https://doi.org/10.31436/imjm.v10i2.677Abstract Introduction: Endometrial biopsy is usually considered unnecessary in post-menopausal uterine bleeding when the endometrial thickness (ET) is less than 5 mm because the risk of endometrial hyperplasia or cancer is low. However, there is still much controversy from this as some believe that the diagnostic value of ET in diagnosis of endometrial pathology (EP) in postmenopausal bleeding is necessary. In this study, the diagnostic value of ET for diagnosis of EP in post-menopausal bleeding was evaluated. Materials and methods: Sixty post-menopausal women with uterine bleeding were evaluated. Transvaginal ultrasonography (TVS) was used for measurement of ET followed by dilatation and curettage in a one-day interval. According to the EP, patients were divided in two groups, normal and abnormal. Endometrial atrophy was considered as normal and hyperplasia, polyps and carcinoma was considered as abnormal. Results: Twenty nine cases had ET more than 6 mm, among them, 25 cases had abnormal pathology (hyperplasia, polyp, cancer) and 4 cases were normal (atrophy). Thirty-one patients had ET equal or less than 6mm, among them, 26 cases were normal (atrophy) and 5 cases had abnormal pathology. The sensitivity, specifi ty, positive and negative predictive values of TVS in the diagnosis of uterine pathology were 83.3%, 86.7%, 86.2%, 83.9% respectively. Conclusion: We suggest that an ET of less than 6 mm in TVS is unlikely to indicate EP in post-menopausal women with uterine bleeding. Downloads Downloads Published How to Cite Issue Section License All material submitted for publication is assumed to be submitted exclusively to the IIUM Medical Journal Malaysia (IMJM) unless the contrary is stated. Manuscript decisions are based on a double-blinded peer review process. The Editor retains the right to determine the style and if necessary, edit and shorten any material accepted for publication. IMJM retain copyright to all the articles published in the journal. All final ‘proof’ submissions must be accompanied by a completed Copyright Assignment Form, duly signed by all authors. The author(s) or copyright owner(s) irrevocably grant(s) to any third party, in advance and in perpetuity, the right to use, reproduce or disseminate the research article in its entirety or in part, in any format or medium, provided that no substantive errors are introduced in the process, proper attribution of authorship and correct citation details are given, and that the bibliographic details are not changed. If the article is reproduced or disseminated in part, this must be clearly and unequivocally indicated.

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