The role of elastography in the differential diagnosis of endometrial pathologies--preliminary report.

Krzysztof Preis, K Zielińska, Małgorzata Świątkowska-Freund, Dariusz Wydra, Juliusz Kobierski
In: Ginekologia polska · 2011 · vol. 82(7) , pp. 494–7 · PMID:21913425 · W142881710
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Elastography effectively differentiated endometrial pathologies from normal endometrium in perimenopausal women by showing higher elastography index scores in pathological cases compared to normal or atrophic findings.

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This preliminary study evaluated whether elastography can distinguish normal or atrophic endometrium from endometrial pathology in 25 perimenopausal women scheduled for dilatation and curettage (D&C) due to transvaginal ultrasound showing a wide endometrium. Using B-mode transvaginal ultrasound plus elastography (ElastoScanR software) and an elastography index (EI), the authors compared EI categories with the pathological diagnoses obtained from D&C. They found a significant difference in EI between women with normal/atrophic endometrium and those with abnormal findings (endometrial cancer, hypertrophy, or polyp), with EI 0–1 corresponding only to normal/atrophic results and EI 2–4 corresponding to pathologic findings. The paper is limited by its small sample size and preliminary design. This paper is centrally about endometriosis—however, it is not about endometriosis or adenomyosis; it focuses on elastography for differentiating endometrial pathologies and was included in the corpus via keyword overlap in the upstream search index.

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Abstract

OBJECTIVES: The aim of the study was to prove the possibility of elastography application in the assessment of the indications for dilatation and curettage (D&C) of the uterine cavity in patients with wide endometrium found in transvaginal ultrasound examination. MATERIAL AND METHODS: Analyzed group consisted of 25 perimenopausal women admitted for D&C due to the suspicion of endometrial hypertrophy. In all the patients transvaginal ultrasound examination in B-mode and elastography by the use of ElastoScan software were performed. Endometrium was described by Elastography Index (EI) presented in previous publications. The results were compared to the pathological results from D&C. RESULTS: Statistical analysis revealed significant difference of elastography image of endometrium described by EI between patients with normal or atrophic endometrium confirmed by pathological examination and women with abnormal findings--endometrial cancer hypertrophy or polyp (chi2 Pearson test; p=0.00005). EI in the group with normal endometrium was 0 or 1 point and in the group with endometrial pathology was from 2 to 4 points. No patient with EI for endometrium above 1 point had normal or atrophic endometrium and no woman with EI 0 or 1 had any pathologic finding. CONCLUSIONS: Elastography as a new diagnostic technique in gynecology seems to be a valuable tool differentiating endometrial pathologies from normal or atrophic endometrium in perimenopausal women with endometrium thickness above 5 mm in transvaginal ultrasound examination.
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Abstract

Abstract Objectives: The aim of the study was to prove the possibility of elastography application in the assessment of the indications for dilatation and curettage (D&C) of the uterine cavity in patients with wide endometrium found in transvaginal ultrasound examination. Material and methods: Analyzed group consisted of 25 perimenopausal women admitted for D&C due to the suspicion of endometrial hypertrophy. In all the patients transvaginal ultrasound examination in B-mode and elastography by the use of ElastoScanR software were performed. Endometrium was described by Elastography Index (EI) presented in previous publications. The results were compared to the pathological results from D&C. Results: Statistical analysis revealed significant difference of elastography image of endometrium described by EI between patients with normal or atrophic endometrium confirmed by pathological examination and women with abnormal findings – endometrial cancer, hypertrophy or polyp (χ2 Pearson test; p=0.00005). EI in the group with normal endometrium was 0 or 1 point and in the group with endometrial pathology was from 2 to 4 points. No patient with EI for endometrium above 1 point had normal or atrophic endometrium and no woman with EI 0 or 1 had any pathologic finding. Conclusions: Elastography as a new diagnostic technique in gynecology seems to be a valuable tool differentiating endometrial pathologies from normal or atrophic endometrium in perimenopausal women with endometrium thickness above 5mm in transvaginal ultrasound examination.

Keywords

elastographytransvaginal ultrasonographyEndometriumhypertrophy of endometriumendometrial cancer

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