EP29.02: Aplication of ultrasonography with elastography in women suspected of endometrial pathologies

Endometrial pathologies suspicion due to ultrasound examination result is a common situation in postmenopausal and perimenopausal women. Such findings are the reason for diagnostic procedures even if there are no clinical symptoms. These invasive procedures are: endometrial biopsy, dilation & curettage and histeroscopy. The aim of this study was to asses whether ultrasound assesment together with elastography aplication could indicate a difference between normal and abnormal endometrium and therefore be a helpful tool to establish further patient management. Endometrium suspected of pathology was assesed and decscribed according to its features like: echogenicity, vascularity, width and elastography index. Patients with intracavitary myomas and were endometrium was impossible to asses were excluded from analysis. Elastography of endometrium was performed using Toshiba Aplio 400 and Medison Accuvix V 10. Elastography index and ultrasound description of endometrium classified as normal or abnormal was saved. The correlation between pathologic results and ultrasound with elastography was analysed. 100 examinations were performed on Toshiba Aplio 400 and 100 on Medison Accuvix V 10. In patients with abnormal ultrasound picture of endometrium elastography index was higher than in those with normal results. The corellation was significant, p < 0,001, regardless the type of machine used. In cases with abnormal picture of endometrium there was higher incidence of confirmed endometrial pathology such as polyp, cancer, atrophy or carcinoma. EI of pathologies was between 3 and 8, the highest indices were in patients with confirmed hyperlasia or cancer. Specyficity and sensitivity of elastography index for pathological result in both groups was calculated and was highest for EI > 3. Elastography proved to be helpfull in differentation between normal and pathological endometrium regardless the technical differences between its applications. We have found the method to be useful as an additional tool together with grey scale assesment.