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Kulbhushan Gupta*, Pranav Pandoh, Sanjay Gupta


Objective: The study was done to compare transvaginal sonographic endometrial assessment with histology obtained by endometrial curettage in postmenopausal patients. It was also addressed whether the technique might have application as either a diagnostic or screening tool for postmenopausal women. Material and methods: The study was performed on 50 postmenopausal women over a period of one year. The transvaginal sonography was performed followed by endometrial curettage. Specimens were sent for histopathological examination. The endometrial thickness measured by transvaginal sonography was correlated with histopathology in each case. Sensitivity, specificity, positive and negative predictive values and accuracy of transvaginal sonography in diagnosing endometrial abnormality at certain cutoff level of endometrial thickness was calculated. Results: Of the 50 postmenopausal women studied 40 had ultrasound measured thickness of 4mm or less. All 40 had histologic diagnosis of atrophic endometrium or low estrogen stimulation or samples were found insufficient for histologic evaluation. Only two women with evidence of atrophic endometrium on histology exhibited transvaginal sonographic endometrial measurements greater than 4mm (5mm and 6mm). Taking 4mm endometrial thickness as cut-off, the sensitivity of transvaginal scan to detect endometrial histology consistent with low estrogen stimulation was 95.2%. The 10 women with TVS measured endometrial thickness greater than 4mm exhibited various histologic diagnosis like proliferative endometrium, endometrial hyperplasia, polyps or endometrial carcinoma.With endometrial thickness greater than 4 mm as measured by TVS, the positive predictive for significant endometrial pathology was 60%. Conclusion: Transvaginal sonography is a simple, safe, non-invasive technique which can be used for evaluating endometrium in both symptomatic and asymptomatic postmenopausal women.

Keywords: Transvaginal sonography; endometrium; postmenopausal; carcinoma.

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