Correlation of transvaginal sonography of endometrium, doppler velocitometry and endometrial histpathology in postmenopausal bleeding

ABSTRACT

In order to evaluate the transvaginal sonography in predicting endometrial pathology in cases of postmenopausal bleeding [PMB], one hundred cases with PMB were studied. In addition to clinical evaluation, transvaginal ultrasonographic evaluation of endometrial thickness, structure echogenicity and endometrial margins were done. Additionally transvaginal study if uterine artery wave form velocimetry as reflected by pulsatility index [P.I.] was measured. These were correlated with the histopathology of the endometrium obtained by fractional curretage. Eighty two women had atrophic endometrium with an verage thickness of 3-4 +/- 1.2 mm. Ten cases had hyperplasia with an average thickness 9.7 +/- 2.5mm, four cases had endometrial polyps with an average thickness 10.8 +/- 4.7mm and three had endometrial carcinoma with thickness of 18.2 +/- 6.2 mm. All cases with nonsignificant lesions showed regular endometrial margins and homogeneous echostructure. The PI for women with nonsignificant lesions was 4.22 +/- 1.06 mm, whereas in women with significant lesions, it was 1.2 +/- 0.37 [p <0.001]. An endometrial thickness of 5 mm and P.I. of 0.2 when taken as cut off points could diagnose all cases with abnormal endometrial pathology