Lewin A, Gabis L, Ushakov F, Anteby S A
Kerem Clinic, Jerusalem.
Harefuah. 1996 May 15;130(10):662-8, 728.
We evaluated the role of transvaginal sonography (TVS) in the investigation of postmenopausal bleeding (PMB) in 50 women with PMB and 25 asymptomatic postmenopausal women presenting for periodic check-up, who served as controls. All those with PMB had a diagnostic curettage or hysterectomy within a week of TVS examination. Measurement of endometrial thickness was compared with the histopathological diagnosis of the endometrium. Of the 32 patients whose endometrial thickness was more than 5 mm, 22 had pathological changes in the endometrium. These included 6 cases of endometrial cancer and 16 with benign changes. All 18 patients of the PMB group with endometrial thickness less than 5 mm had normal endometrial histology. Endometrial thickness in all asymptomatic controls was less than 5 mm. Our results showed endometrial thickness greater than 5 mm to be 100% sensitive and 64% specific in identifying endometrial pathology. TVS follow-up without curettage may be considered for PMB patients with uniform endometrium less than 5 mm thick.
我们评估了经阴道超声检查（TVS）在50例绝经后出血（PMB）患者及25例无症状绝经后定期体检女性（作为对照）中对PMB的诊断作用。所有PMB患者在TVS检查后一周内均接受了诊断性刮宫或子宫切除术。将子宫内膜厚度测量结果与子宫内膜组织病理学诊断结果进行比较。在32例子宫内膜厚度超过5mm的患者中，22例子宫内膜有病理改变。其中包括6例子宫内膜癌和16例良性改变。PMB组中所有18例子宫内膜厚度小于5mm的患者子宫内膜组织学正常。所有无症状对照者的子宫内膜厚度均小于5mm。我们的结果显示，子宫内膜厚度大于5mm在识别子宫内膜病变方面敏感性为100%，特异性为64%。对于子宫内膜厚度小于5mm且均匀的PMB患者，可考虑不进行刮宫而采用TVS随访。
