Transabdominal and transvaginal ultrsonographic evaluation of cases of perimenopausal bleeding

ABSTRACT

The present work tested the diagnostic accuracy of transabdominal ultrasound [TAS] and transvaginal ultrasound [TVS] in 100 cases with perimenopausal bleeding relative to the pathological diagnosis. 52 patients had proliferative endometrium, 34 had endometrial hyperplasia, 5 had secretory endometrium, 4 had endometrial carcinoma, 3 had retained products of conception, and 2 had atrophic endometria. TAS had 87.5%, while TVS had 90.8% overall diagnostic accuracy. When endometrial thickness was <10 mm [TAS] or <12 mm [TVS] endometrial carcinoma was not reported and hyperplasia was unlikely. When uterine length was <80 mm hyperplasia/carcinoma was rare and when the length was >120 mm the incidence was more than 35%. When myometrial invasion was not detected the possibility of malignancy was only 2%. Ultrasonography [USG] detected associated or causative lesions correctly in nearly 88% of such cases. It detected endometrial carcinoma missed by D and C biopsy in 2 occasions. USG seems to have an important complementary role in evaluating cases of perimenopausal bleeding. TVS had marginal advantage over TAS, though it is not free of limitations that may need further evaluation