The Usefulness of Vaginal Sonography in Evaluation of Endometrium in Postmenopausal Women

Woo, B W; Jeon, K S; Lee, H Y; Lee, Y K; Lee, D J; Lee, S H

Abstract

The purpose of this study was to evaluate the usefulness of transvaginal ultrasonography in postmenopausal women with endometrial pathology. Transvaginal ultrasound scanning was performed on 100 postmenopausal women. Of these women, 26 had postmenopausal bleeding and all the malignancies were found in the group of women with vaginal bleeding. The endometrial thickness and texture were used as indicators of endometrial abnormalities. The ultrasound findings were related to the endometrial histopathologies obtained from the hysterectomy or curettage specimens. In 59 of these the endometrium was normal and the endometrial thickness by ultrasound was less than 4mm. In 20 patients the endometrial histology was abnormal and ultrasound endometrial thickness was 4mm or greater. In 20 patients the endometrium was atrophic, but the ultrasonic endometrial thickness was apparently greater than 4mm. Of these women 4 were in the group on hormonal replacement therapy. Histologically, endometrial hyperplasia was found in 15% of the women and endometrial polyp and cancer in 4% and 2%. If the endometrium was less than 4mm, no endometrial cancer was found at histopathological investigation. By using a cut off point of 4mm of ultrasonographically measured endometrial thickness for identification of endometrial pathology in this study, at least 60% of the curettages could be spared. So we suggest that an endometrial thickness of 4mm is an appropriate cut off level and vaginal ultrasonography is useful method for conservative management of patients with postmenopausal bleeding, or in screening for endometrial pathology.