بررسي ضخامت اندومتر با سونوگرافي ترانس واژينال و رابطه آن با نتايج بيوپسي اندومتر و بيوپسي با هدايت هيستروسكوپ در بيماران با خونريزي پس از يائسگي

The relationship of endometrial thickness detected by transvaginal sonography with the results of endometrial biopsy & hysteroscopic directed biopsy in post menopausal bleeding

Background: Post-menopausal hemorrhage is one of the most common compla ins in gyneco logic clinics. More than 60% o f the se cases have abnorma l findings in dia gnostic work ups. There is co ntra versy ab out the best dia gno stic meth od for ev alu ating postmenopausal hemorrhage. Th e a im of this s tudy was to evalua te the result s of Tran sVagin al Ultrason ograph y and compare its result to ones deriv ed from direct endo metria l biops y and Hysteroscop y findings. Methods: In a cross -sec tional s tudy, men opaus al women who attended the outpatient clin ic of Ara sh Hospital , Tehran University of medi cal Sciences, from April 2005 to March 2006 with the compla in of hemorrh age were ev alu ated . In all of these pati ents, afte r getting informed co nse nt, Trans -Vagina l Ultrasonography, Dilatation and Cure ttage and Hyst eroscop y were perform ed . Results: The tot al number of 90 women was recru ited to the study with the age range of 41-80 yea rs. Th e mean age of participants was 53.84 ± 6 yea rs and 4.3 ± 5.1 yea rs had passed from their menopause . Th e mean thickn ess of endometrium, mea sured by Tran s Vaginal ultrasonography was 6.25 ± 3.7 millimeter. In the biopsy derived specimens, the most finding path olo gi cal pr esentation was atrophy (48.9%) and the Proliferative endometrium had the second prevalence (36.7%). Atrophy (44.4%) and Pr oliferati ve endometrium (33.3%) wer e the most pre val ent finding in Hysteroscopy. There was a significa nt difference in endometria l thickness between groups of different path olo gical findings. A significant difference in endometrial thickn ess was also seen between groups with different Hyster oscopic finding. By group ing the data acc ording to endometri al thickness, it became ev ide nt that endo met rial thickn ess can predi ct the outcome of endometrial biopsy and Hystero scopic finding effic iently. We used ROC curves to find the best grouping thresh old for endometrial thi ckn ess to achiev e the bes t sens itiv ity and specific ity . Conclusion: Measuring the end ometrial thickness by Trans -Vag inal Ult rasonography is an appropriate non-invasive test for scree ning post-menopausal hemorrhage