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Erschienen in: Archives of Gynecology and Obstetrics 4/2010

01.10.2010 | General Gynecology

Evaluation of endometrial thickness with transvaginal ultrasonography and histopathology in premenopausal women with abnormal vaginal bleeding

verfasst von: Suna Özdemir, Çetin Çelik, Kazım Gezginç, Demet Kıreşi, Hasan Esen

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2010

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Abstract

Objective

This study was undertaken to investigate cut-off value of the endometrial thickness by transvaginal ultrasonography (TvUSG), and to detect the accuracy of preoperative Pipelle biopsy in premenopausal women with abnormal vaginal bleeding.

Study design

This study was included 144 premenopausal women with abnormal bleeding. Their endometrial thickness was measured by TvUSG and then Pipelle endometrial biopsy was performed. Preoperative histopathologic findings of 57 women who were operated were compared with final histolopathologic examination.

Results

Of the 144 women, 113 (78.4%) had normal and 31 (21.6%) had an abnormal endometrium. The abnormal endometrium was composed of 11.8% hyperplasia (simple + atypical complex), 4.2% endometrial polyp, and 5.5% adenocarcinoma. An optimal sensitivity and specificity (83.6 and 56.4%, respectively) and negative predictive value with 95.6% for detection of abnormal endometrium were obtained with an endometrial thickness of 8 mm. The accuracy rate of preoperative Pipelle biopsy was 94.7% in a total of 57 women.

Conclusion

An endometrial thickness >8 mm is more likely than that of 8 mm or less to be indicated with endometrial biopsy in premenopausal uterine bleeding. Pipelle endometrial biopsy is an accurate diagnostic procedure for the detection of high-grade endometrial lesions in premenopausal women.
Literatur
1.
Zurück zum Zitat Bettocchi S, Ceci O, Vicino M, Marello F, Impedevo L, Selvaggi L (2001) Diagnostic inadequacy of dilatation and curettage. Fertil Steril 75:803–805CrossRefPubMed Bettocchi S, Ceci O, Vicino M, Marello F, Impedevo L, Selvaggi L (2001) Diagnostic inadequacy of dilatation and curettage. Fertil Steril 75:803–805CrossRefPubMed
2.
Zurück zum Zitat Dubinsky TJ (2004) Value of sonography in the diagnosis of abnormal vaginal bleeding. J Clin Ultrasound 32:348–353 (review)CrossRefPubMed Dubinsky TJ (2004) Value of sonography in the diagnosis of abnormal vaginal bleeding. J Clin Ultrasound 32:348–353 (review)CrossRefPubMed
3.
Zurück zum Zitat Gupta JK, Chien PFW, Voit D, Clark TJ, Khan KS (2002) Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta-analysis. Acta Obstet Gynecol Scand 81:799–816CrossRefPubMed Gupta JK, Chien PFW, Voit D, Clark TJ, Khan KS (2002) Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta-analysis. Acta Obstet Gynecol Scand 81:799–816CrossRefPubMed
4.
Zurück zum Zitat Smith-Bindman R, Kerlikowske K, Feldstein VA et al (1998) Endovaginal ultrasound to exclude endometrial cancer and other endometrial abnormalities. JAMA 280:1510CrossRefPubMed Smith-Bindman R, Kerlikowske K, Feldstein VA et al (1998) Endovaginal ultrasound to exclude endometrial cancer and other endometrial abnormalities. JAMA 280:1510CrossRefPubMed
5.
Zurück zum Zitat Van Doorn LC, Dijkhuizen PHLJ, Kruitwagen RFMP, Heintz AP, Kooi GS, Mol BW (2004) DUPOMEB (Dutch Study in Postmenopausal Bleeding): accuracy of transvaginal ultrasonography in diabetic and or obese women with postmenopausal bleeding. Obstet Gynecol 104:571–578PubMed Van Doorn LC, Dijkhuizen PHLJ, Kruitwagen RFMP, Heintz AP, Kooi GS, Mol BW (2004) DUPOMEB (Dutch Study in Postmenopausal Bleeding): accuracy of transvaginal ultrasonography in diabetic and or obese women with postmenopausal bleeding. Obstet Gynecol 104:571–578PubMed
6.
Zurück zum Zitat Gull B, Karlsson B, Milsom I, Granberg S (2003) Can ultrasound replace dilatation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer. Am J Obstet Gynecol 188:401–408CrossRefPubMed Gull B, Karlsson B, Milsom I, Granberg S (2003) Can ultrasound replace dilatation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer. Am J Obstet Gynecol 188:401–408CrossRefPubMed
7.
Zurück zum Zitat Goldstein RB, Bree RL, Benson CB et al (2001) Evaluation the women with postmenopausal bleeding: Society of Radiologists in Ultrasound-Sponsored Concensus Conference statement. J Ultrasound Med 20:1025–1036PubMed Goldstein RB, Bree RL, Benson CB et al (2001) Evaluation the women with postmenopausal bleeding: Society of Radiologists in Ultrasound-Sponsored Concensus Conference statement. J Ultrasound Med 20:1025–1036PubMed
8.
Zurück zum Zitat Vercellini P, Cortesi I, Oldani S, Moschetta M, De Giorgi O, Crosignani PG (1997) The role of transvaginal ultrasonography and outpatient diagnostic hysterescopy in the evaluation of patients with menorrhagia. Hum Reprod 12:1768–1771CrossRefPubMed Vercellini P, Cortesi I, Oldani S, Moschetta M, De Giorgi O, Crosignani PG (1997) The role of transvaginal ultrasonography and outpatient diagnostic hysterescopy in the evaluation of patients with menorrhagia. Hum Reprod 12:1768–1771CrossRefPubMed
9.
Zurück zum Zitat Goldstein SR, Zelster I, Horan CK, Snyder JR, Schwartz LB (1997) Ultrasonography-based triage for perimenopausal patients with abnormal uterine bleeding. Am J Obstet Gynecol 177:102–108CrossRefPubMed Goldstein SR, Zelster I, Horan CK, Snyder JR, Schwartz LB (1997) Ultrasonography-based triage for perimenopausal patients with abnormal uterine bleeding. Am J Obstet Gynecol 177:102–108CrossRefPubMed
10.
Zurück zum Zitat Schwarzler P, Concin H, Bosch H et al (1998) An evaluation sonohysterography and diagnostic hysteroscopy fort he assessment of intrauterine pathology. Ulrasound Obstet Gynecol 11:337–342CrossRef Schwarzler P, Concin H, Bosch H et al (1998) An evaluation sonohysterography and diagnostic hysteroscopy fort he assessment of intrauterine pathology. Ulrasound Obstet Gynecol 11:337–342CrossRef
11.
Zurück zum Zitat Chittacharoen A, Theppisai U, Linasmita V, Manonaj J (2000) Sonohysterography in the diagnosis of abnormal uterine bleeding. J Obstet Gynaecol Res 26:277–281CrossRefPubMed Chittacharoen A, Theppisai U, Linasmita V, Manonaj J (2000) Sonohysterography in the diagnosis of abnormal uterine bleeding. J Obstet Gynaecol Res 26:277–281CrossRefPubMed
12.
Zurück zum Zitat Pasrija S, Trivedi SS, Narula MK (2004) Prospective study of saline infusion sonohysterography in evaluation pf perimenopausal women with abnormal uterine bleeding. J Obstet Gynaecol Res 30:27–33CrossRefPubMed Pasrija S, Trivedi SS, Narula MK (2004) Prospective study of saline infusion sonohysterography in evaluation pf perimenopausal women with abnormal uterine bleeding. J Obstet Gynaecol Res 30:27–33CrossRefPubMed
13.
Zurück zum Zitat Getpook C, Wattanakumtornkul S (2006) Endometrial thickness screening in premenopausal women with abnormal uterine bleeding. J Obstet Gynaecol Res 32:588–592CrossRefPubMed Getpook C, Wattanakumtornkul S (2006) Endometrial thickness screening in premenopausal women with abnormal uterine bleeding. J Obstet Gynaecol Res 32:588–592CrossRefPubMed
14.
Zurück zum Zitat Dueholm M, Jensen ML, Laursen H, Kracht P (2001) Can the endometrial thickness as measured by trans-vaginal sonography be used to exclude polyps or hyperplasia in pre-menopausal patients with abnormal uterine bleeding? Acta Obstet Gynecol Scand 80:645–651CrossRefPubMed Dueholm M, Jensen ML, Laursen H, Kracht P (2001) Can the endometrial thickness as measured by trans-vaginal sonography be used to exclude polyps or hyperplasia in pre-menopausal patients with abnormal uterine bleeding? Acta Obstet Gynecol Scand 80:645–651CrossRefPubMed
15.
Zurück zum Zitat Batool T, Reginald PW, Hughes JH (1994) Outpatient Pipelle endometrial biopsy in the investigation of postmenopausal bleeding. Br J Obstet Gynaecol 101:545–546PubMed Batool T, Reginald PW, Hughes JH (1994) Outpatient Pipelle endometrial biopsy in the investigation of postmenopausal bleeding. Br J Obstet Gynaecol 101:545–546PubMed
16.
Zurück zum Zitat Clark TJ, Mann CH, Shah N, Khan KS, Song F, Gupta JK (2002) Accuracy of outpatient endometrial biopsy in the diagnosis of endometrial cancer: a systematic quantitative review. BJOG 109:313–321CrossRefPubMed Clark TJ, Mann CH, Shah N, Khan KS, Song F, Gupta JK (2002) Accuracy of outpatient endometrial biopsy in the diagnosis of endometrial cancer: a systematic quantitative review. BJOG 109:313–321CrossRefPubMed
17.
Zurück zum Zitat Dijkhuizen FP, Mol BW, Brölmann HA, Heintz AP (2000) The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta analysis. Cancer 89:1765–1772CrossRefPubMed Dijkhuizen FP, Mol BW, Brölmann HA, Heintz AP (2000) The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta analysis. Cancer 89:1765–1772CrossRefPubMed
Metadaten
Titel
Evaluation of endometrial thickness with transvaginal ultrasonography and histopathology in premenopausal women with abnormal vaginal bleeding
verfasst von
Suna Özdemir
Çetin Çelik
Kazım Gezginç
Demet Kıreşi
Hasan Esen
Publikationsdatum
01.10.2010
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 4/2010
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-009-1290-y

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