Karlsson B, Granberg S, Hellberg P, Wikland M
Department of Obstetrics and Gynecology, Sahlgrenska Hospital, University of Göteborg, Sweden.
J Ultrasound Med. 1994 Oct;13(10):757-62. doi: 10.7863/jum.1994.13.10.757.
Dilatation and curettage is used as the "gold standard" for diagnosing pathologic endometrial lesions in women with postmenopausal bleeding. In this group of women, about 10% have an endometrial cancer and an additional 20% have some other endometrial abnormality. However, some abnormalities, such as endometrial polyps and submucous fibroids, are difficult to diagnose by dilatation and curettage. In such cases, combining transvaginal sonography with hysteroscopy may be of value. This study compared the use of transvaginal sonography and hysteroscopy for evaluation of the uterine cavity in women with postmenopausal bleeding. The study included 51 women, 39 of whom had an abnormally thick ( > 4 mm) endometrium as measured by transvaginal sonography, and 35 of 39 had an abnormal appearance at hysteroscopy. The sensitivity and specificity for the measurement of endometrial thickness using transvaginal sonography to diagnose an endometrial abnormality were 100% and 75%, respectively. The corresponding figures for hysteroscopy were 97% and 88%. In all women with an endometrial thickness of 8 mm as measured by transvaginal sonography, hysteroscopy is identified as an abnormality. The study indicates that transvaginal sonography reveals an endometrial thickness of > or = 8 mm and the histopathologic diagnosis after dilatation and curettage is atrophic endometrial polyp or submucous myoma.
诊断绝经后出血女性的病理性子宫内膜病变时，刮宫术被用作“金标准”。在这类女性中，约10%患有子宫内膜癌，另有20%存在其他子宫内膜异常。然而，一些异常情况，如子宫内膜息肉和黏膜下肌瘤，通过刮宫术很难诊断。在这种情况下，经阴道超声检查与宫腔镜检查相结合可能会有帮助。本研究比较了经阴道超声检查和宫腔镜检查在评估绝经后出血女性子宫腔方面的应用。该研究纳入了51名女性，其中39名经阴道超声检查显示子宫内膜厚度异常增厚（>4mm），这39名中的35名在宫腔镜检查时外观异常。经阴道超声检查测量子宫内膜厚度以诊断子宫内膜异常的敏感性和特异性分别为100%和75%。宫腔镜检查的相应数字为97%和88%。在所有经阴道超声检查显示子宫内膜厚度为8mm的女性中，宫腔镜检查均发现异常。该研究表明，经阴道超声检查显示子宫内膜厚度≥8mm，刮宫术后组织病理学诊断为萎缩性子宫内膜息肉或黏膜下肌瘤。
