Van den Bosch T, Van Schoubroeck D, Domali E, Vergote I, Moerman P, Amant F, Timmerman D
Department of Obstetrics and Gynecology, University Hospitals Leuven, K.U. Leuven, Belgium.
Ultrasound Obstet Gynecol. 2007 Jun;29(6):674-9. doi: 10.1002/uog.4031.
To evaluate the clinical and sonographic features in patients with endometrial malignancy in whom endometrial thickness on ultrasound examination had been recorded in our database to be < 5 mm.
This was a retrospective observational study on 187 consecutive patients diagnosed with endometrial malignancy in whom an ultrasound evaluation of the endometrium had been performed in our institution. The characteristics of those patients presenting with an endometrial thickness < 5 mm were analyzed.
The median endometrial thickness was 15 mm: 12 mm for the women who underwent endometrial sampling before ultrasound examination vs. 17 mm in those who did not (P = 0.0086). In 13 women (6.9%), the endometrial thickness recorded in our database was < 5 mm. In 12 of these the measurement was compromised in some way: nine of these patients had undergone endometrial sampling (Pipelle biopsy in one and dilatation and curettage in eight patients) before the ultrasound examination, in two cases, focal malignant lesions were not included in the recorded endometrial thickness and in one, the endometrial thickness was visualized poorly due to myometrial distortion. In only one case was was the endometrium correctly measured to be < 5 mm; this woman had diffuse uterine and endometrial metastases of a breast cancer.
A thin and regular endometrial line is very reliable for the exclusion of endometrial carcinoma. The suspicion of focal lesions as well as incomplete visualization of the endometrium on sonography should be considered abnormal. Recently performed endometrial sampling makes measurement of the endometrial thickness unreliable.
评估在我们数据库中超声检查记录的子宫内膜厚度<5mm的子宫内膜恶性肿瘤患者的临床和超声特征。
这是一项对187例连续诊断为子宫内膜恶性肿瘤且在我们机构接受过子宫内膜超声评估的患者进行的回顾性观察研究。分析了那些子宫内膜厚度<5mm患者的特征。
子宫内膜厚度中位数为15mm：超声检查前接受子宫内膜采样的女性为12mm，未接受采样的女性为17mm（P = 0.0086）。在13名女性（6.9%）中，我们数据库记录的子宫内膜厚度<5mm。其中12例测量存在某种问题：9例患者在超声检查前接受了子宫内膜采样（1例为 Pipelle活检，8例为刮宫），2例中局部恶性病变未包含在记录的子宫内膜厚度中，1例因子宫肌层变形导致子宫内膜厚度显示不佳。只有1例子宫内膜被正确测量为<5mm；该女性患有乳腺癌的弥漫性子宫和子宫内膜转移。
薄且规则的子宫内膜线对排除子宫内膜癌非常可靠。超声检查时怀疑有局灶性病变以及子宫内膜显示不完全应被视为异常。近期进行的子宫内膜采样会使子宫内膜厚度测量不可靠。
