Sheth S, Hamper U M, Kurman R J
Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21205.
Radiology. 1993 Apr;187(1):135-9. doi: 10.1148/radiology.187.1.8451399.
A correlative sonographic and histopathologic analysis was performed in 35 postmenopausal women with greater than 5-mm thickening of the endometrium at pelvic sonography. Women undergoing estrogen replacement were excluded from study. Four distinct sonographic patterns were encountered. Pattern 1 consisted of echogenic endometrium with small cysts (endometrial polyp with cystic hyperplasia [n = 9], atrophic endometrium with cystically dilated glands [n = 5], and atrophic endometrium [n = 3] at microscopic examination). Pattern 2 was homogeneous echogenic endometrium (proliferative endometrium [n = 3] and adenomyomatous polyp [n = 1]). Pattern 3 was irregular, inhomogeneous endometrium with ill-defined hypoechoic areas (endometrial carcinoma [n = 5], complex hyperplasia with atypia [n = 1], blood clots [n = 1], and atrophic endometrium with eosinophilic metaplasia [n = 1]). Pattern 4 was thin endometrium with fluid in the endometrial cavity (scant atrophic endometrium [n = 6]). Thus, an endometrial thickness of greater than 5 mm in postmenopausal women is associated with a variety of pathologic conditions. Subclassification of sonographic patterns may be helpful in differentiating benign cystic atrophy or cystic endometrial hyperplasia from malignant endometrial lesions.
对35名绝经后妇女进行了超声与组织病理学相关性分析，这些妇女盆腔超声检查显示子宫内膜增厚超过5毫米。接受雌激素替代治疗的妇女被排除在研究之外。发现了四种不同的超声模式。模式1为有小囊肿的高回声子宫内膜（显微镜检查显示为子宫内膜息肉伴囊性增生[n = 9]、萎缩性子宫内膜伴腺体囊性扩张[n = 5]以及萎缩性子宫内膜[n = 3]）。模式2为均匀的高回声子宫内膜（增殖期子宫内膜[n = 3]和腺肌瘤样息肉[n = 1]）。模式3为不规则、不均匀的子宫内膜，有边界不清的低回声区（子宫内膜癌[n = 5]、复杂性非典型增生[n = 1]、血凝块[n = 1]以及伴有嗜酸性化生的萎缩性子宫内膜[n = 1]）。模式4为子宫内膜薄且宫腔内有液体（少量萎缩性子宫内膜[n = 6]）。因此，绝经后妇女子宫内膜厚度大于5毫米与多种病理状况相关。超声模式的亚分类可能有助于区分良性囊性萎缩或囊性子宫内膜增生与恶性子宫内膜病变。
