Imaging of the endometrium in postmenopausal women

Ultrasound can offer cheap, quick, relatively non-invasive assessment of the endometrium in postmenopausal women. Its inability to effectively discriminate benign from malignant pathology means its place is to select those in whom further investigation is required. Saline instillation sonography may allow clarification of the image and allow the discrimination of a submucosal fibroid with thin overlying endometrium from a central uterine homogeneous mass seen on standard transvaginal ultrasound. In addition it may identify eccentric endometrial thickening or other intracavity lesions. The role of three-dimensional ultrasound is ill defined at present and magnetic resonance because of its cost should be confined to complex cases.