Transvaginal sonography of the endometrium in postmenopausal women.

TLDR

The study compared transvaginal sonographic assessment of uterine and endometrial thickness with histologic findings from biopsy or curettage to evaluate its usefulness in postmenopausal women. Eighty postmenopausal women were examined, including 65 asymptomatic (38 not on hormone therapy and 27 on hormone replacement) and 15 with postmenopausal bleeding. Sonographic endometrial thickness ≤4 mm reliably indicated estrogen‑deprived endometrium, whereas thickness 5–8 mm could not differentiate proliferative from hyperplastic or low‑grade carcinoma, but large polyps and invasive carcinoma with myometrial invasion were readily identified.

Abstract

The purposes of this study were to compare transvaginal sonographic scanning of the uterus and endometrium with histology obtained by endometrial biopsy or curettage and to determine whether the sonographic technique might be useful in the evaluation of postmenopausal women. Eighty postmenopausal women were studied. Of these, 65 were asymptomatic (38 on no hormone therapy and 27 on hormone replacement). Fifteen women underwent evaluation because of postmenopausal bleeding. In both groups, endometrial thickness of 4 mm or less as depicted by sonography correlated well with endometrial characteristics of decreased estrogen stimulation. However, in women with measured endometrial thickness between 5-8 mm, proliferative endometrium could not be distinguished from hyperplastic endometrium or, in one case, low-grade carcinoma. Large polyps and invasive carcinoma with myometrial extension were easily recognized.