[Early diagnosis of endometrial disorder in women with postmenopausal bleeding by three-dimensional transvaginal sonography and hysterosonography].

OBJECTIVE

To evaluate the value of three-dimensional transvaginal sonography and hysterosonography in the diagnosis of endometrial lesion in women with postmenopausal bleeding.

METHODS

A total of 74 patients with postmenopausal bleeding were prospectively studied by two- and three-dimensional transvaginal sonography. Endometrial thickness and volume were measured by 2D and 3D ultrasound respectively. Endometrial thickness was found by hysterosonography at greater than 5 mm in 32 cases. Changes of endometrium and compliance of muscularis uteri were observed. The results were correlated with histopathological findings.

RESULTS

When 10 ml of endometrial volume was set as the cut-off point of endometrial abnormalities in postmenopausal women with bleeding, the sensitivity and false positive rate were 95.4%, 21.2% whereas 100%, 18.2% were obtained respectively when it was used to predict endometrial malignancy and premalignancy. The accurate rate of 2D-HSG diagnosing endometrial disorders and endometrial malignancy and pre-malignancy was 96. 8% and 100% respectively. Changes of endometrium and compliance of muscularis uteri showed a significant difference between the groups of benign and malignancy after the injection of fluid into uterine cavity (P < 0.05).

CONCLUSION

3D-TVS and 2D-HSG are reliable methods in screening endometrial lesions. 2D-HSG should be regarded as an important tool in diagnosing and differentiating endometrial lesions especially in early stages of this malignant disease. Changes of endometrium and compliance of muscularis uteri may help to differentiate benign disorders from endometrial cancer.