Stachowiak Grzegorz, Zając Agnieszka, Pertynska-Marczewska Magdalena, Stetkiewicz Tomasz
Department of Gynecology and Gynecological Oncology, Polish Mother's Memorial Hospital Research Institute, Rzgowska Str. 281/289 Lodz, Poland.
Ginekol Pol. 2016;87(12):787-792. doi: 10.5603/GP.2016.0089.
2D/3D transvaginal ultrasonography in evaluation of endometrium in postmenopausal women with abnormal uterine bleedings (AUB).
2D/3D transvaginal ultrasonography (TVU) was performed in 118 menopausal women with AUB. Endometrial volume and thickness, uterine volume and endometrial vascularity were evaluated. Complete histologic evaluation of the endometrium was obtained through dilatation & curettage (D&C) and/or hysteroscopy. Accordingly, patients were divided into 3 groups: controls (no endometrial pathology, n = 49), GI (benign endometrial pathology, n = 37), GII (endometrial carcinoma, n = 32).
GII had greater thickness and volume of the endometrium, compared to GI and controls. The presence of arterial vascular flow was identified only in GI and GII (51.35% and 93.75%, respectively). Endometrial volume merged together with uterine volume measurements (TVU-3D) showed a strong, statistical significance between GI and GII, allowing differentiation of begin and malignant endometrial pathologies in postmenopausal women.
In TVU diagnostics of postmenopausal women with AUB the following play the most significant role: 1) endometrial thickness (TVU-2D); 2) endometrial volume (TVU-3D); 3) uterine plus endometrial volume (TVU-3D); 4) vascularization within the endometrium, allowing to differentiate between pathological and normal endometrium (TVU-2/3D). Evaluation of the endometrial vascularity, both in TVU-2D and TVU-3D technique, does not allow for reliable differentiation between benign lesions and endometrial cancer.
探讨二维/三维经阴道超声检查在绝经后异常子宫出血（AUB）患者子宫内膜评估中的应用价值。
对118例绝经后AUB患者进行二维/三维经阴道超声检查（TVU），评估子宫内膜体积、厚度、子宫体积及子宫内膜血管情况。通过刮宫术（D&C）和/或宫腔镜检查获取完整的子宫内膜组织学评估结果。据此，将患者分为3组：对照组（无子宫内膜病变，n = 49）、GI组（良性子宫内膜病变，n = 37）、GII组（子宫内膜癌，n = 32）。
与GI组和对照组相比，GII组子宫内膜厚度和体积更大。仅在GI组和GII组发现动脉血流信号（分别为51.35%和93.75%）。二维/三维经阴道超声测量的子宫内膜体积与子宫体积合并分析显示，GI组和GII组之间差异具有统计学意义，有助于鉴别绝经后女性的良性和恶性子宫内膜病变。
在绝经后AUB患者的经阴道超声诊断中，以下因素起最重要作用：1）子宫内膜厚度（二维经阴道超声）；2）子宫内膜体积（三维经阴道超声）；3）子宫加子宫内膜体积（三维经阴道超声）；4）子宫内膜血管化情况，有助于区分病理性和正常子宫内膜（二维/三维经阴道超声）。二维和三维经阴道超声技术评估子宫内膜血管情况，均无法可靠地区分良性病变和子宫内膜癌。
