Title: Evaluation of Endometrial Thickness in Females with Post Menopausal Bleeding
Authors: Dr Chetna Dhamija, Dr CL Thukral
DOI: https://dx.doi.org/10.18535/jmscr/v8i5.69
Abstract
The study evaluated the endometrial thickness in post menopausal bleeding subjects with trans-vaginal /trans-abdominal ultrasonography and further the endometrial thickness was correlated with histopathological findings. This diagnostic study included 50 females who presented with postmenopausal bleeding. All females were subjected to transvaginal ultrasonographic evaluation of the endometrial thickness. These females further underwent dilatation and curettage procedure to obtain endometrial curettings which were subjected to histopathological examination. In the present study 50 females between ages 44 to 68 years were included. Out of the total 50 females who presented with post menopausal bleeding 9 females were diagnosed with endometrial carcinoma, 18 females with endometrial hyperplasia, 16 with benign endometrial glands ,6 with atrophic endometrium and 1 with endometrial polyp on histopathological examination after dilatation and curettage. Mean endometrial thickness was significantly more in cases of malignancy as compared to benign conditions (21.83 vs 11.32 mm; p<0.01). Endometrial thickness was observed to be a significant predictor for malignancy (Area under ROC was 0.844; p-value <0.01) with sensitivity and specificity of 88.9% and 63.4% at a cut-off of 11.7 mm. Although transvaginal sonography endometrial thickness can be used as a screening tool in discriminating normal from abnormal endometrium but cannot differentiate benign from malignant endometrium.
References
- Padubidri, V.(2014).Shaws Textbook of Gynaecology .16th Elsvier Health Sciences APAC,pp.65-79.
- Abdel Maboud, N. and Elsaid, H. (2015). Role of transvaginal ultrasonography and colour Doppler in the evaluation of postmenopausal bleeding. The Egyptian Journal of Radiology and Nuclear Medicine, 46(1), pp.235-43.
- Kurjak A, Shalan H, Sosic A, Benic S, Zudenigo D, Kupesic S et al. Endometrial carcinoma in postmenopausal women: Evaluation by transvaginal color Doppler ultrasonography. Am J of Obstet 1993;169(6):1597-603.
- Bourne T, Campbell S, Steer C, Royston P, Whitehead M, Collins W. Detection of endometrial cancer by transvaginal ultrasonography with color flow imaging and blood flow analysis: A preliminary report. Gynecologic Oncology. 1990;40(3):253-9.
- Incim Bezircioglu, Ali Baloglu, Burcu Cetinkaya, Seyran Yigit and Ergun Oziz, The diagnostic value of the Doppler ultrasonography in distinguishing the endometrial malignancies in women with postmenopausal bleeding, Archives of Gynecology and Obstetrics, 1007/s00404-011-2159-4, 285, 5, (1369-1374), (2011).
- Dijkhuizen FP, Parolmann HA, Heiaz AP and Potters AE: The accuracy of transvaginal ultrasonography in the diagnosis of endometrial abnormalities. Obstest. Gynecol, 87 (3):345-349, 1996.
- Bano I, Mittal G, Khalid M, Akhtar N, Arshad Z. A study of endometrial pathology by transvaginal colour Doppler ultrasonography and its correlation with histopathology in post-menopausal women. Indian Med Gazette 2013:134–9.
- Weiner Z, Beck D, Rottem S, Brandes J, Thaler I. Uterine artery flow velocity waveforms and color flow imaging in women with perimenopausal and postmenopausal bleeding: Correlation to endometrial histopathology. Acta Obstetricia et Gynecologica Scandinavica. 1993;72(3):162-6.
- Epstein E, Skoog L, Isberg P, De Smet F, De Moor B, Olofsson P et al. An algorithm including results of gray-scale and power Doppler ultrasound examination to predict endometrial malignancy in women with postmenopausal bleeding. Ultrasound Obstet Gynecol. 2002;20(4):370-6.
- Alcázar J, Castillo G, Mínguez J, Galán M. Endometrial blood flow mapping using transvaginal power Doppler sonography in women with postmenopausal bleeding and thickened endometrium. Ultrasound Obstet 2003;21(6):583-8.